Active Vs Passive Therapy: Why It Matters
Passive therapies involve the provider doing treatment to or for you.
If you follow any medical accounts on social media, you may realize this is a hot topic. A very hot topic. There are people arguing for both sides. Truth is both sides have some value, but one side probably has more than the other.
Passive Therapy includes “traditional” PT and chiropractic treatments, like heat/ice, electric stim, ultrasound, massage, manipulations (adjustments), etc. But it also includes some of the new wave versions: dry needling, compression guns, foam rollers, compression boots, red light, sauna, laser, shockwave therapy and more. These are treatments where someone (or thing) does something for you. All you do is lay/sit and have a treatment performed. We are often told these will “fix” our issues.
Active Therapy is just that: active. You do movement. The movement might be assisted or resisted by bands, weights, balls, machines, or even your therapist. But you are moving. You have an active role in your recovery.
Active therapy involves your provider guiding you through becoming a functional human or improving your current performance.
If I had to choose between the two, I will always choose active. I can do any treatment under the sun for you/to you. But when you leave my space, you are an active human (or at least I hope you are). Even if you have a sedentary job or are retired, you have light activity involved in just being alive- moving around your house or work space, driving a car, shopping, cooking, daily hygiene, etc. This means my passive treatment will only go so far before your active movements revert back to where they were… Leaving you reliant on coming to see me again.
Is this a great business model? Heck yes! But is this great for humans? Maybe not. Active treatment means you start to understand how your body moves, how to modify or make changes to movement, and how to be a more active human (with less pain, ideally). But does this mean there is no role for passive treatment?
Absolutely not. There is a time and a place for passive treatments. Acute pain and restricted motion? Sure. Swelling after an injury? No problem. A little flare up from a traveling or attending a conference where your activity changed significantly? Yup. A little passive treatment can go a long way in reducing pain in the moment. However, for most people, these benefits are short lived. What makes the BIGGER difference in your overall outcome is the Active portion of your treatment plan.
How can you find a provider who will help you with this? Ask some questions! Instead of only asking “Do you do dry needling or adjustments?”, try these:
How often do you usually see clients for this issue? For how long?
What types of treatments do you provide?
Will I be moving during our session, or on a table most of the time?
Will I learn things to work on in between our sessions?
If my pain is really limiting me, what options do you have to help calm it down?
How will we know when it’s time for discharge?
Will you provide me a plan to maintain the progress we’ve made?
Pay attention to Red Flags regarding your treatment!
Answers from these questions will vary a lot. And that’s OK. We don’t all think or treat the same way. Some Red Flag answers to these questions could be:
Long durations of care for relatively common/normal conditions (or high frequency for a long time)
Lying on a table for most of a treatment
No homework or activities between sessions
No plan for discharge
No plan for maintenance
I want to firmly reiterate that no two treatment plans will be the same. No two providers will treat the same way. That doesn’t mean one is wrong or right. But it may mean one isn’t right for you. If you only want to lie on a table for massage and some stim, then find that provider— but expect to be seeing them for a long time (and for a lot of money). If you want longer-lasting results, find a provider who will work with you to establish independence towards your goal.
View your therapist (or other pain manager) as a “guide” rather than your “fixer” and you might be surprised at your outcomes!
