Inflammation and Mobilisations

Hi Everyone

Im a physio student and got so frustrated with studying I had to join here and ask these questions:

1. Are Spinal Manipulations the same as Spinal Mobilisations?as in maitland?

2. If inflammation is a contraindication to manual therapy then how come it is said to be effective in regards to the pain gate mechanism and fluid etc. as these are present during inflammation.And this may seem like a stupid question but also, how come manual therapy like soft tissue massage is used post hamstring injuries etc if it is contraindicated when inflammation is present?The reason i ask is because alot of the time i read that the treatment for a back problem is anti-inflammatories and manual therapy which seems to contradict itself.

My questions might seem stupid I think iv been studying for too many hours and my mind is fuzzy :)

Consider the irritability of the patient's symptoms in acute inflammatory phase. Irritability in a nutshell describes how easy it is to provoke the patient's symptom and how quickly it abates after the aggravating factor is removed. e.g. a highly irritable condition is easily provoked and takes relatively longer period of time to settle the symptom. High irritability is more common during the inflammatory phase and therefore manual therapy is usually avoided, in another word, you don't want to make the patient worse.
Of course, not all inflammations are of the same magnetitude and therefore irritability. In the scenario of hamstring strain, you would probably carry out manual therapy if the patient has low irritability, even during acute phase e.g. in a low grade strain. Whereas if the patient can not bear you touching the injured area, you would reconsider manual therapy.
I hope this makes sense as it is not always cut and dry in clinical setting. It would be useful to take irritability into account to make these clinical decision vs. following a set protocal in managing injuries.