Individuals coming in for massage or physiotherapy as part of their treatment have likely heard therapists distinguish between "passive" and "active" techniques. While these are two distinctive methods of treatment, they are nonetheless often used in tandem for patients who are recovering from an injury. What is the difference, then, between active and passive physiotherapy?
The distinction between these two terms essentially comes down to patient movement: passive physiotherapy techniques are treatment methods that do not require the patient to move their muscles and joints. This may be because a patient's muscles are still too weak to complete certain exercises, or that the patient is still experiencing too much pain or discomfort to undertake more active exercises. Passive physiotherapy thus primarily involves pain management with the goal of eventually being able to advance to a more active approach. Passive treatment methods can include applying heat to relax tight muscles, using cryotherapy to reduce inflammation of damaged muscles, or using an ultrasound machine to deeply stimulate certain muscles and gradually improve the range of motion of the muscle or joint. Acupuncture can also be used to stimulate certain muscles and both reduce pain and improve range of motion.
Active physiotherapy is a step up from passive methods in that a patient will begin to see actual joint and muscle movement as part of the therapy. This may at first involve stretching muscles or moving joints, with or without the aid of a physiotherapist. As a patient improves their range of motion and strengthens their damaged muscles, they may graduate to using a stationary bike or walking on a treadmill. Massage therapy can also be considered an active treatment method, as this involves the kneading and movement of sore and recovering muscles in order to improve circulation to a damaged area and stimulate the body's natural healing processes. Other active physiotherapy techniques that may be employed are light weight lifting and balance exercises, which can be particularly important for those who are recovering from ankle or knee injuries that require balance practice.
It is important to note that active and passive treatment techniques go hand-in-hand, and they may even be used in a single session: a passive therapy will help to warm up muscles and reduce pain, followed by active strengthening work. It is essential that patients have a personalized recovery plan combining the two.