Connective Tissue Manipulation (CTM) is a technique performed by physiotherapists when applying the pads of their fingers to ‘roll’ a patient’s skin tissues. Its effectiveness is based on viscerocutaneous reflex (discovered by the Chinese in the East and then 2000 years later in the West by Sir Henry Head in 1890). It is a great technique for the treatment of back pain and sciatica.

All of the structures in the body are surrounded, supported and protected by a connective type of tissue that binds together the body’s organs and provides compartmentalization between them. When connective type tissue receives appropriate contact and energy, it changes very quickly. This characteristic ensures that a physiotherapist is either working on muscle or connective tissue, but not both at the same time, which allows them to be very specific in what they do.

CTM works because the movement of the tissues by the physiotherapist creates a short, sharp, nervous stretch reflex that creates an impulse that spreads throughout them. The patient’s brain will translate the impulse as if it were a scratch to the skin. Basically, the tighter the tissue is, the bigger the stretch reflex and therefore the sharper the scratch felt by the patient. The reflex itself is a small electrical impulse that passes through the fluid in the connective type tissue and releases tension. This reduction in tension around the blood vessel walls lets more blood flow into the damaged area, reducing inflammation. Softening the connective tissue allows more movement to occur without irritation and pain.

Treatment will often start away from the injured part, gradually working in closer. The benefits of CTM are cumulative. Once the tension has been lowered through treatment the reduction is maintained. Further reduction in connective tissue tension occurs with each treatment.

The degree to which the reduction in connective tissue tension is maintained is dependent upon the level of stress added put on the body by the patient’s lifestyle. CTM is only learnt at advanced level in the UK and is not yet widely available from physiotherapists.

Connective tissue therapy is practiced by The London Physio Centre and the Physio Centre, Gillingham. If you are suffering from back pain or sciatica, visit their websites to find out how they can help you.

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