Rehabilitation, A Beginner’s Guide

A Brief History 

Do you have a shoulder, low back or knee pain? You are interested in rehabilitation and want to know more.  Examining the history of rehabilitation can help you understand the speciality more. You can better decide if rehabilitation is for you.

Rehabilitation is a health speciality for the treatment of musculoskeletal pain and disorders. Chronic low back pain, knee osteoarthritis, frozen shoulder and hip impingement are common types of musculoskeletal pain and disorders.

Most people would seek help when they have a stiff back, knee or shoulder, but may not know they can also seek treatment for pain that appears on the more distal parts of the body like foot plantar fasciitis, trigger finger, thumb bursitis and tennis elbow. For example, if you have a stiff finger or heel pain when you take your first steps every morning, these areas are also treatable with rehabilitation.

The word rehabilitation comes from Latin prefix re-, meaning “again” and the word habitare, meaning “make fit.”  Therapy — often associated with rehabilitation — originated from the Greek word  therapeia or “healing.” 

STARTED IN ANCIENT GREECE

While rehabilitation as a health speciality did not exist until the 1940s, manual therapy and exercise —two key features of rehabilitation — had been around for thousands of years. 

If you have watched K-drama, “Extraordinary Attorney Woo,” one of Netflix’s most watched drama in 2022, you couldn’t miss the inverted table, a sleek motorised bed that brings you upside down. You would have seen Attorney Jang, one of the characters in the show, hanging upside down on the table to stretch and relax. Can you imagine this ultra-cool device for stretching was invented some 2,500 years ago?

Ancient Greek Hippocrates (460-386 BCE)— the father of medicine — described the use of such a device to straighten the spine, according to a 2007 study on a history of manipulative therapy.

Hippocrates was the first physician to use manipulative techniques to treat spinal disorders, according to the study, published in the Journal of Manipulative and Manual Therapy. Hippocrates recorded his cases. In one case, the patient was tied to a ladder and inverted. Inversion, he wrote, allowed the head and trunk to act as a pulling force to stretch the spine.

THE ORIGIN OF TREATMENT TABLES

Hippocrates also wrote about using a table with straps, wheels and axles, the study showed. The table allowed him to lay the patient down for treatment. Traction and focal pressure would be applied to the spine by hand or with a wooden lever. Sometimes to increase the focal pressure, a foot or seated body weight was used.

The Hippocratic Table was the precursor of the traction table and massage table used for treatment today. Imagine these treatment tables have been around for thousands of years. Ancient Greeks were having their spine adjusted on these tables. But thankfully, some methods such as applying a foot and sitting on a patient did not catch on. 

Exercise as a tool for rehabilitation also existed throughout the millennium. Ancient civilisations developed elaborate exercise systems for health and disease prevention, according to a study in 2015, which examined the history of physical and rehabilitation medicine. For examples, the Ancient Greeks developed gymnastics, while the Chinese had kung fu, a form of martial art, to improve health and prevent diseases. Gymnastics and kung fu are still widely practiced today. 

PHYSICAL THERAPY & POLIO

Manual therapy and exercise methods developed through the centuries, but would largely operate on the fringes of mainstream medicine until the turn of 20th century. The intensity of the polio epidemic from 1900 – 1950s, and the volume of injured soldiers returning home after World War II brought rehabilitation to the forefront of modern healthcare.  

The number of polio survivors and WWII veterans who needed care created an urgent need for staff and expertise to treat physical disabilities. Physical therapy (or physiotherapy) came into prominence in the 1920s in America, and was instrumental in the in the development of treatment and exercise for polio care, according to a study in 2021, published in the Physical Therapy and Rehabilitation Journal. 

Polio or poliomyelitis is a disabling and deadly disease which infects a person’s spinal cord, and causes paralysis where the person is unable to move parts of the body. Most of the victims were children. 

Physical therapists introduced hot baths, swimming in heated pools and exercises to help polio survivors manage the symptoms and improve strength, said Naomi Rogers, the researcher of the 2021 study. “Active polio therapy” replaced splints and casts, which were earlier thought to prevent muscle atrophy. Children survivors were no longer confined in beds or sent to “crippled children’s homes,” Rogers said.

WORLD’S FIRST REHAB CENTRE

The end of World War II in 1945 was another watershed event. The volume of injured soldiers returning home after the war increased demand for rehabilitation. More rehabilitation facilities were set up. In 1951, Dr. Howard A. Rusk started the world’s first comprehensive rehabilitation centre at New York University, according to the 2015 study, published in the American Medical Association’s Journal of Ethics.

The NYU centre was the first rehabilitation centre to offer physical, neuropsychological and occupational therapies. Rehabilitation medicine was introduced, and doctors who specialise in rehabilitation medicine are known as physiatrists.

PRACTICE OF MANUAL THERAPY BROADENS

More hospitals would set up rehabilitation centres, but rehabilitation also flourished outside of the hospitals. The practice of physical therapy spread across the world. It reached the shores of post-war Australia and New Zealand with Robin McKenzie, Stanley Paris and Geoffrey Maitland the leading lights of physical therapy in the 1960s.

Innovative works on manual therapy by Paris and Maitland, and in Europe, by Freddy Kaltenborn and Gregory Grieve would modernise manual therapy and make the study of manual therapy a specialty in its own right, the 2007 study on a history of manipulative therapy showed. Techniques were updated and assessment methods were improved.

In 1970, the International Federation for Orthopaedic Manual Therapy was established as a sub-group of physical therapy. The inception of IFOMT helped promote and advance the study of manual therapy. Manual therapy was introduced to other practices. Today, manual therapy is practiced not only physiotherapists, but also by clinical orthopedic manual therapists and kinesiologists.

The 1950 to 1970 was also a period of creativity. Apart from improving strength, improving movement in the body also became an emphasis in exercise. New exercise methods for rehabilitation such as Feldenkrais and Rolfing were created. The works by the pioneering group of manual and movement therapists would laid the cornerstone for the movement revolution in 2000.

MOVEMENT REVOLUTION

American Thomas Myers, whose work on fascia would influence a whole new generation of rehabilitation workers, was a trained manual and movement therapist. He counted Drs. Ida Rolf and Moshe Feldenkrais among his influence.

Myers was the first person to map the fascia lines in the body. Fascia are soft connective tissues that cover the whole body. He discovered fascia are not randomly arranged as earlier believed, but are organised like train lines, connecting the different parts of the body. There are fascial lines that run anteriorly, posteriorly, laterally and contra-laterally, that keep the body in balance. As a result, any tension in an area of body not only affects the area, but also other parts of the body connected by the fascial line. 

RISE IN SPORTS & PUBLIC INTEREST

Myers published his groundbreaking work in a book called the “Anatomy Trains” (2001). His work created seismic changes in treatment strategies for rehabilitation, and exercise and strength training. Instead of lifting weights using weight machines, athletes were on their feet moving, shoving and balancing on stability balls. Tests were created to assess functional movement to screen for muscle imbalance and potential injury. More athletes and sport coaches were interested in rehabilitation.

Interest from the sport community in turn brought more public interest and awareness to the benefits of rehabilitation. There are many how-to videos on YouTube today, not all by professionals, eager to show you how you can rehab your shoulder, knee or back.

Myers’ work also influenced treatment strategies of physical and manual therapy. Rather than treating one part of the body as before, improving a person’s posture and alignment, or structural balance also became part of the rehabilitation process. Myofascial release — a treatment to release fascia tension — was introduced. The treatment became popular with athletes and fitness enthusiasts who would perform different types of myofascial release to avoid injury.

THE MANY FACES OF REHAB

Rehabilitation has become a health speciality for musculoskeletal pain and disorders. Rehabilitation is practiced in hospitals, but there is also a vibrant mix of rehabilitation services available outside of the hospitals. The introduction of manual therapy to other practices helped spurred the growth of rehabilitation. Today, manual therapy is practiced not only by physiotherapists, but also by manual therapists and kinesiologists.

Similarly, many physiotherapists have also adopted other practices, such as Pilates and dry needling. So when you see a physiotherapist, you may receive more than physiotherapy. Pilates is an exercise method best known to strengthen core muscles. Dry needling is a treatment method influenced by Chinese acupuncture.

There are also more exercise instructors trained in rehabilitation than before, and Pilates and exercise studios have special programmes designed for rehabilitation.

HOW YOU CAN BENEFIT

What does it mean for someone with a shoulder, back or hip pain, or with a painful wrist or finger? Wrist and finger pain are more common, as we spend more time typing at our desk and on our mobile devices. If you have one of these pain, you have more options than before. It is easy to find a rehabilitation facility near you. The pain is more treatable when you seek help early.

For someone with more chronic pain and movement restriction, rehabilitation is a good alternative to medication and surgery. You can weigh the pros and cons, and decide which one or which combination is the best or better solution for you. For example, medication is often used for pain relief. You can decide on a longer term basis, whether rehabilitation could be a better option.

If you have a musculoskeletal pain or disorder, don’t wait. Start today. Be part of the movement culture.

We offer clinical orthopedic manual therapy for rehabilitation with the option to combine Pilates and/or personal training. Select from below the programme that best suits you:

Rehabilitation Programmes

Find relief from neck pain and tension headache

Neck Care

Do you have tension headache, or tight neck and upper back muscles? Are they causing you a lot of discomfort? What you will receive from the session:

  • An assessment of the pain and range of motion
  • Manual therapy to loosen tension on the neck, back and shoulders: find relief from the headache and shoulder tension, feel better
  • Improve neck movement: look up, down and turn your head without pain
  • Receive stretching exercises for the neck muscles which you can do at home
  • Access to Pilates at no extra charge to improve posture and upper body strength for more long-term relief; Pilates is included at no extra charge
  • Receive exercise progression so that you could improve further

Sign up for a trial today

NECK CARE

Find Relief from Shoulder Pain

Shoulder Care

Does your shoulder or shoulder blade muscles feel achy all the time? Do you have difficulty doing overhead exercises, or moving the arm behind the body? Try manual therapy. What you will receive from the session:

  • An assessment of the pain and range of motion
  • Manual therapy to loosen tension on arm and shoulder: feel better
  • Improve arm and shoulder movement: raise your arm, take your arm to the side, front and back without pain
  • Receive stretching and strengthening exercises which you can do at home
  • Access to Pilates exercises to improve upper body strength and posture for more long term relief; Pilates is available at no extra charge
  • Receive exercise progression so that you could improve further

Sign up for a trial today

SHOULDER CARE

Manual therapy for back pain relief

Back Care

A key predictor of low back pain or injury is a prior injury. Research showed over two-third of individuals with chronic back pain have a recurrence within 12 months after recovery. As a result, it is important to be in a Back Care programme. What you will receive from the session:

  • An assessment of the pain and range of motion 
  • Manual therapy to loosen tension on the lower back: feel better
  • Improve movement: bend over or extend your back to reach out for an object without pain
  • Receive stretching exercises which you can do at home
  • Access to Pilates to improve core strength to reduce back pain and for more long-term relief
  • As your core and back muscles become stronger, your need for manual therapy lessens but at times, the back pain may re-surface; having access to manual therapy allows you to address the pain early and exercise with confidence

Sign up for a trial today

BACK CARE

Manual therapy for hip pain relief

Hip Care

Do you have pain on the side of your hips when you walk? Does the pain spread to the front and back upper thigh? Or do you feel you have one leg longer than the other? You don’t feel balance. Hip pain can happen to anyone due to muscle tightness from overuse, or joint stiffness due to age. Try manual therapy. What you will receive from the session:

  • An assessment of the pain and range of motion 
  • Manual therapy to loosen tension around the hips: feel better
  • Improve hip movement: move your legs to the side and back more freely, walk with less restriction
  • Receive stretching exercises which you can do at home
  • Access to Pilates exercise to improve hip movement and strengthen core muscles for more pelvic and lumbar stability; feel more balance
  • Strengthen pelvic floor muscle, reduce incontinence (leaky urine) and tone your abs!

Sign up for a trial today

(65) 6996 4396 today or sign up below.

Manual therapy for knee pain relief and movement

Knee Care

You want to exercise and stay fit, but the knee pain is preventing you from doing more. If the pain is persistent, and certain area of the knee feels tight, try manual therapy. What you will receive from the session:

  • An assessment of the pain and range of motion
  • Manual therapy to loosen muscle tension on the knee joint: feel better
  • Improve knee movement: improve knee flexion and extension, walk and climb stairs without restriction
  • Receive stretching exercises for the knee which you can do at home
  • Address the leg misalignment such as bowed leg or knocked knee for more long-term relief; also address related pain such as back or hip pain which may come with the knee pain
  • You’ll have access to Pilates exercises to stretch and strengthen leg muscles and improve alignment; Pilates is included at no extra charge

Sign up for a trial today

KNEE CARE

Manual therapy for ankle pain relief

Ankle Care

Are you prone to ankle sprains and foot cramps? Does your heel feel painful when you take your first step every morning? Or is the pain more on the lateral side of the foot? The bunion at the foot has become worse over the years. Does your ankle locked up when you try to walk more? As our feet and ankles bear the full weight of the body when we stand, walk or run, tension and tightness may happen. What you will receive from the session:

  • An assessment of the pain and range of motion 
  • Manual therapy to loosen tension on the ankle and foot: feel better
  • Improve ankle movement, walk with less restriction
  • Receive stretching exercises which you can do at home
  • Access to Pilates exercise to improve ankle movement; practice different footwork on the Pilates reformer: lessen ankle sprains and foot cramps
  • Improve leg alignment, find more long-term relief

Sign up for a trial today

(65) 6996 4396 today or sign up below.

Manual Therapy for wrist pain relief

Wrist Care

Most people would seek help when they have stiff shoulders, but may not know they can also seek treatment for pain that appears on the distal body like the wrists and fingers. Does your wrist hurt when you turn a knob or lift a cooking pot? Do you have a finger that is locked and won’t bend easily? Too much swiping on the mobile devices in addition to long hours on the laptop can result in overuse. What you will receive from the session:

  • An assessment of the pain and range of motion
  • Manual therapy to loosen tension on the finger/s and wrist: feel better
  • Improve movement at the fingers and wrists
  • Receive stretching and strength exercises which you can do at home
  • Access to Pilates at no extra charge to improve alignment, as well as wrist and grip strength for more long-term relief
  • Receive exercise progression so that you could improve further

Sign up for a trial today

(65) 6996 4396 today or sign up below.

Manual therapy for elbow pain relief

Elbow Care

Sometimes having to bear more weight than before on the forearm, such as carrying a baby to sleep on a bended arm, or typing for long periods of time without an elbow rest can strain the elbow. Or you may enjoy playing tennis or golf or a paddle sport like SUP or kayak, which requires moving the forearm with force. The action can also cause elbow pain. What you will receive from the session:

  • An assessment of the pain and range of motion 
  • Manual therapy to loosen tension at the elbow: feel better
  • Improve elbow movement: flex and extend the elbow without restriction
  • Receive stretching and strength exercises which you can do at home
  • Access to Pilates at no extra charge to improve alignment, as well as elbow and wrist strength for more long-term relief
  • Receive exercise progression so that you could improve further

Sign up for a trial today

(65) 6996 4396 today or sign up below

Start Today

    Take the first step. The form just takes one minute to fill.

    Your Name*

    Your Email*

    Your Mobile*

    YES! Sign me up for the following trial (please select one):

    Describe your painful joint/s & fitness goals:

    You will receive an email confirmation from us shortly.

    Testimonials

    Thanks to Pilates, Life Feels Great Without Neck Pain

    Through a series of private Pilates classes, my long-term neck problem completely disappeared! May diagnosed my body condition and identified the root cause of my neck issue. Life has never been so easy for me!
    Joway

    Waking Up with Less Back Pain, Can't Wait for My Next Session

    May has magic hands! I’d been experiencing chronic and acute lower back pain for quite some time and tried various things to no avail. During my first visit with May, she not only released tension in the relevant muscles, but also taught me how to engage my core muscles properly. Just by looking at how I walk or move, she knows exactly which muscles need work. I now wake up to much less pain coz I learned how to release the tension in my lower back. I can’t wait for my next session with her.
    Eileen

    Better Body Alignment & Awareness

    After a few sessions with May, I realize if I don’t center my body when I walk and stand, all the pains in my right knee and lower back returns. Now I consciously seek to distribute equal weight to both legs and align my body when I walk. Thanks May!
    Faith

    Able to Sit on Hard Chairs, Feel Refresh

    I’d been having back pain when I sit. I couldn’t sit for long because of the pain. Sitting for a meeting became a problem. Since yesterday after the session (of manual therapy and Pilates,) I experienced a vast improvement. I'm able to sit even on hard chairs. When I got home yesterday, I was completely exhausted and slept very well. I am refreshed today. Thank you.
    Sylvia

    Recover From Wrist Injury

    May has a wide experience in this field. Her physiology expertise is guaranteed 100%, as she has mastered the ability to see, touch & feel every vein, muscle, tendon and joint to pinpoint the inflammation (on my wrist.) I have a wrist injury that occured 6 months ago. I recently completed 6 sessions with her. My condition has improved tremendously. I have gained back my confidence in executing complex exercise movements, thanks to her.
    Leonard

    Given Me Hope That I'll Walk Normally Again

    May has given me hope that I will in the near future, be able to walk normally again with minimal pain in my knees. She is great at getting to the root of the problem, in correcting muscular imbalances through manual therapy, pilates and home exercises. Thank you, May!
    Christina

    Reversing The Effects of Sitting

    I spend lots of hours sitting on a chair, in front of my laptop and that's harmful for my body and specially my back. I see May every week for Pilates and she helps me restore balance, finding healthier postures for my body and releasing from the weekly erosion.
    Gloria

    Ease the Effects of Chemotherapy

    Cancer and chemotherapy have greatly affected and changed my body and mind. During chemotherapy, I have developed chemotherapy-induced peripheral neuropathy. A year into post chemotherapy, the side effects, pain and discomforts lingered on. My hands and legs were frequently stiff, swollen and tingling with pins and needles. I was struggling with fatigue, balance and mobility. I met May at Move Therapy in January 2018. Her studio is no frills but well equipped and personable. May did not paint me any rosy promises or rainbow illusions. She did some evaluations and suggested we can start with some rehabilitation and strengthening workouts. I never looked elsewhere after our initial workout and I have been going to her since. Thanks to her guidance and motivation, I have physically improved and no longer suffering in pain and discomfort. The tingling pins and needles in my hands and feet have much subdued and most important, I am no longer struggling with my balance and mobility.
    K Foo

    Relieves Knee Pain, Improves Fitness

    I'm glad to have May as my Pilates instructor. May has helped me with my bad knee through exercises and orthopedic manipulation. She is also very patient, and committed to my body's improvement beside my knee.
    Ai Lin

    A surprisingly pleasant intro to Pilates

    Thank you for a very surprisingly pleasant introduction to Pilates. I am an experienced athlete and a professional diver with chronic stiffness in the neck and shoulders. Today, I found new skills to augment what I already knew, and a focus on proper technique for great results. I felt very effectively engaged.
    Eddie

    Knee exercises and activities that I can continue on my own

    Working overseas, I came back to Singapore for a short four week holiday and thought I should get some Pilates classes to further strengthen my weak knee due to a meniscus tear. I found Move Therapy by googling and signed up for my 1-to1 trial class. May went through my problem and what the doctors did for me. She then designed a set of exercises and activities which I could continue on my own when I go back to work, overseas. After my first trial lesson, I was just so amazed by the differences in my legs. When I arrived back in Singapore, although I’ve recuperated from the meniscus tear through physiotherapy and physical therapy at the hospital, my legs still felt swollen and stiff. I was not able to bend my knees. My attempts at swimming, which was recommended by the doctor, was hard, as I wasn't sure how to move anymore. After my first session with May, my leg muscles felt more relaxed and subsequent sessions continued to make me feel I’m near full recovery. The exercises and activities May prescribed were easy enough to continue at home and in a gym anywhere I go. Thanks!
    Angelina

    The Best Part, My Lower Back Pain Has Gone Away

    I attended Pilates classes because of my lower back pain that came about after National Service. I had fears prior to joining May’s Pilates session as the only guy in class, but her non-judgemental attitude very quickly eased my worries and concerns. I started to enjoy the sessions more and more each week with her patient guidance. The best part is that now my lower back pain has gone away!
    Sean

    Each session I see improvement

    I was fortunate to connect with May at Move Therapy to heal my shoulder and back issues. On day one, she did a thorough assessment of my posture and range of motion. She made a great exercise plan for me. With each session I could see the improvement, and magically my pain went away. Still before starting each session, she would assess then adjust the exercises accordingly. Thank you May for relieving my pain and giving me a new understanding on how I can maintain my body balance and posture!! I strongly recommend Move Therapy to anybody who is in pain, and if you are not in pain, the sessions will let you gain a new understanding of the human body.
    Rohit

    NO MORE BACK PAIN, HEADACHE

    "I suffered from severe upper back pain and headache in 2012 - 2013.  At the same time, I was also suffering from back pain, leg cramps and weak ankles. I was introduced to May for manual therapy and exercise. She not only loosened but also showed me how to loosen the tight muscles on my own, using balls and rollers gradually, through a well thought-out program. She was always patient. She never forced me to do exercises which I thought that were quite beyond me. I learned good posture, and how to maintain good standing and sitting postures. I really appreciate May’s help in solving my chronic pain and correcting my bad posture."
    Cheng Duan

    NO MORE KNEE PAIN

    "I was so worried about climbing Wutai Shan (Shanxi, China) because I'd knee pain. I wanted to  perform the Buddhist rite of walk, pray and kneel on every three steps up the 1,080 stairs of the sacred mountain. It was the main reason for going. It would be very difficult to do with my kneecap problem. My sister recommended Move Therapy to me. After one session, I was so surprised there was no more pain on my kneecap. I felt I was walking with very light steps. The relief was so immediate, it took me by surprise. Of course, I continued to roll after, using the foam roller. It wasn't just from one class at Move Therapy, but the class showed me how to and on which area of my legs I should focus on when I roll. I was able to walk, pray and kneel up Wutai Shan. A wish come true. No knee pain. Thank you."
    Beng Lee

    MY BACK FEELS BETTER

    "I'm in my early 20s. Having a lower back strain for close to 3 years, I can really feel the difference after attending May's Pilates group lessons. I’ve been attending for 10 weeks. I can feel that my posture has improved significantly and my back doesn't hurt as often as before. Thank you!"
    Andrew

    KEEP PAIN AWAY ACTIVELY

    "I'd dizzy spells and headache. They were so bad that I’d been unable to work. I saw many health professionals and nothing worked until I saw May. In my one-to-one sessions, May relieved the tension from my neck and shoulders, and she showed me how I can actively keep the pain away through rolling and exercise. With exercise, my legs are also stronger. I can walk further. I climbed Mt Fuji in Japan with my husband in 2015. A year ago, I won't have thought I would be able to join my husband on the trip up Mt Fuji."
    Shubha

    NO MORE FEAR

    "I’d persistent lower back pain after giving birth to my daughter. I saw many healthcare professionals, but my back didn’t get better. But since starting my private sessions, my pain has gone. Before I didn’t want to move out of fear my back would act up, but not anymore. I’ve started running, and recently completed a 5-km run. Thank you!"
    Dian

    You may also like

    Common causes of wrist painWhy Wrist Pain Can Happen To Anyone

    5 Common Causes for Wrist Pain & Injury

    Does doing daily activities like lifting a box or holding a plate trigger a sudden and sharp pain at the wrist? Are you frustrated by the wrist pain and loss of strength? Find out why the wrist muscles become tight and painful, the causes for carpal tunnel syndrome, trigger finger and more…

    Learn More

    Remedy for Sport InjuriesManual Therapy & Pilates As A Remedy for Sport Injuries

    Are you active and fit? You want to do more, but you have a painful joint which increases with activity.

    Sport injuries can be broadly classified into two groups, traumatic and overuse injuries. Overuse injuries are more common of the two injuries. According to strength coach, Michael Boyle, the problem with sport medicine is it treats all injuries as traumatic injuries…

    Learn More
    Benefits of Strength Training
    Photo source: the New York Times

    Back Pain: OMG! Who Shrunk the Buttocks?

    The Case For Strength Exercises And Manual Therapy

    You can blame it on fashion. Our love of baggy jeans have resulted in the disappearance of the buttocks. But the bigger culprit is our sedentary lifestyle. We have wasted away the most powerful muscles in the body.

    Buttock atrophy is believed to be the cause of low back pain and a host of other muscle and joint pain related to the lower body.

    Learn More