Noel Gressner, Physical Therapist at Miami Orthopedics and Sports Medicine Institute, suggests doing exercises in a position that does not provoke pain.
He also says manual physical therapy is a way of using joint manipulation, joint mobilization, among others to try to treat the spine, and part of the recovery is the manual hands-on treatment technique.
Stress fractures and I wanted to just touch upon real quick what exercises do you suggest someone do it they have one You would call spinal stabilization core stabilization it’s a global term so to speak so going back to what movements someone has increased back pain in you try to stay out of that so someone with a stress fracture in their spine you want to start out strengthening in more of a neutral spine so if I use the spine and I’m flexing that’s out of neutral if I’m hyper extended I’m out of neutral so doing exercises in a position basically that don’t provoke pain you could almost define it as that but biomechanically it would be from one extreme to another in terms of what the joints are able to produce but then exercising in a particular posture that doesn’t provoke pain. All right perfect now I understand obviously you’re an expert in physical therapy and you focus mostly on manual therapy what is that? Manual physical therapy is a way using joint manipulation joint mobilization soft tissue mobilization hands-on work to try to treat the spine and so part of that is not just treatment part of that is the physical examination so if I’m looking at your spine and I’m looking at bony landmarks what does your pelvis doing what is your different bony landmarks on your sacrum and so if your pelvis has rotated if I’m looking at this pelvis or if I’m looking at the heights of your iliac crest or if I’m looking at what’s called a posterior superior iliac spine and you’re rotated forward or if your sacrum certain bony landmarks on your sacrum are turned one particular way then then you use those things as a manual assessment and then you use manual techniques to try to detone muscles with muscle activation mobilizing joints and there’s different grades of that depending upon the necessary treatment but that’s manual therapy in a nutshell would be inclusive of diagnostic in terms of hands on then treatment manual hands-on treatment technique.