Conventional physiotherapy is defined as the treatment of movement disorders caused by impairments of joints and the muscles that move the joints.
In practice, many physiotherapists attribute movement disorders to changes in joint mobility and thus apply specific, mobilisation-based treatment techniques (osteopathy, chiropractic, manipulative therapy, etc.). Others attribute movement disorders to muscle weakness and therefore recommend limb and/or core muscle strengthening exercises.
Lastly, some physiotherapists suspect a lack of muscle extensibility, which is therefore countered by applying stretching-based treatments (stretching, the Mézières method, etc.).
Mobilisation, strengthening and stretching constitute the three main treatment approaches in physiotherapy. Depending on the supposed origin of the disorder, the physiotherapist will opt for the corresponding treatment approach. The supposed origin is referred to as the disease hypothesis. It underpins, supports and justifies the treatment approach. In the absence of a disease hypothesis, the treatment approach will be ill-defined and will have variable and sometimes only temporary effects.
Lower back pain is an emblematic example because there is no scientific consensus on the aetiology of this very common pathology. In the absence of a clear cause, a lack of back muscle efficiency is often supposed. Hence, in most cases, the applied physiotherapeutic techniques converge on muscle strengthening and stabilization of the painful zone. The physiotherapist seeks to optimize muscle contractility by exercising it through repeated postural or dynamic exercises. Upstream of the exercised muscles, the nervous system transmits “orders” from the brain’s voluntary command centres located in the cerebral cortex (the brain’s outer layer).
The direct stimulation of contractility (i.e. from cortex to nerve to muscle) forms part of many different physiotherapy methods used to these pathologies.