What’s Wrong With Manual Therapy?

We hear complaints from doctors that there’s such focus on exercise in physical therapy practice that manual therapy is often excluded. This is ironic given that Google returns 50,400,000 results from “manual therapy” searches. Plus, the results are positive, and large chains even advertise manual therapy.

The reason for this is a mystique of sorts  that surrounds hands-on interventions that is related to how they work and how effective they are.

What is Manual Therapy?

Physical therapists use their hands to work on joints and soft tissue. Patients receive passive or assistive care that helps the neck, upper back, lower back, hips, knees, ankles, wrists, and elbows to move better. Additionally, therapists mobilize muscles, tendons, and fascia in a way that promotes lymph drainage, the loosening stiff muscles, and the removal of tissue adhesions that are painful and inhibit movement. As a result, patients experience relaxation, reduced pain, and a reduction in swelling. Ultimately, manual therapy helps patients regain complete range of motion, good posture, and proper movement.

What’s The Problem?

However, angst and caution over the use of manual therapy abounds. It appears to result from several things: how physical therapy students are taught, the temporary effects of manual therapy, and a lack of research into how it works.

Angst mostly exists among younger therapists because teaching programs emphasize exercise-based interventions and heavily caution hands-on interventions. While experienced therapists are more comfortable using manual therapy, our collective experience tells us that some clinics are so busy that manual therapy is left out of treatment programs. While manual modalities are effective, they are most effective in conjunction with exercise. So, they are an added step.

This promotes a sort of mystique of manual therapy. After all, we know that manual therapy works. We know that physical therapy has contributed a lot of knowledge to the practice of bodywork. We know what mobilizations and manipulations to perform. Meanwhile, the evidence of neurophysiology—how manual therapy affects the nervous system—is strong but less voluminous.

Manual Therapy at Be Fit

Hands-on modalities are effective and yet temporary. Yes, there’s no magic bullet. What is certain is that they are most effective in conjunction with supervised therapeutic exercise and exercise prescribed for the home.

Be Fit is committed to doing manual therapy. We dedicate ourselves to the safe, and proper application of the most effective interventions. We have seen how they help patients with post-surgery scar tissue, for example.
In addition to pain and dysfunction caused by joint disorders pre-surgery, scar tissue causes its own problems. We use manual techniques such as MyoKinestetic Therapy to help reduce pain.

Types of Manual Treatments

  • joint mobilization
  • joint manipulation
  • muscle stretching
  • passive movements
  • active resistance (improves muscle activation and timing)

“Manual Therapy.” Physiopedia. https://www.physio-pedia.com/Manual_Therapy. Accessed 27 December 2019

“Manual Therapy in Physiotherapy Practice with Jesse Awenus.” The Canadian Physio Student, Nov. 18, 2018. Youtube. https://youtu.be/g36vqjx5N-Q. Accessed 27 December 2019