For someone wanting to begin physical therapy, the new vocabulary can be confusing. One phrase that is probably new to most people is “manual therapy”. The terminology can cause many to ask questions such as, “What is manual therapy?” “Will my treatment include manual therapy?” “Is manual therapy distinct from physical therapy?” “How do I find a manual therapist?”
All of these are great questions, and we here at EW Motion Therapy want you to be as informed as possible when you begin physical therapy treatment.
Manual therapy may not be suitable for every patient. Still, because manual therapy can be an integral part of treatment plans, this beginner’s guide will help you understand what manual therapy is and how it may be incorporated into your treatment.
So what is manual therapy?
Manual therapy is a primary modality of physical therapy. It is a skilled application of hands-on techniques by skilled clinicians to manipulate soft tissue, joints, and nerves. Manual therapy is important for multiple body systems, because hands-on manipulation can be very effective to decrease pain and tissue tension, improve quality of movement, and guide a patient through their exercises.
For example, let’s say you are having stiffness in your hip. During your sessions in the clinic, your therapist may employ manual therapy techniques like joint and soft tissue mobilization and/or massage to improve your range of motion and decrease stiffness and discomfort when you walk.
Your therapist will assign exercises and stretches that you can complete independently, but manual therapy techniques applied by a skilled therapist can take your treatment to the next level. Unfortunately, not every physical therapist will use manual therapy in your treatment - application depends on your sensitivity, your stage in the healing process, and the potential benefits of the technique.
Benefits of manual therapy
Manual therapy has many benefits, including reduced pain, reducing stress and strain, increasing joint mobility and soft tissue health, increased blood flow, and reduced inflammation. Along with appropriate exercise progression, the addition of manual therapy to your treatment is a great way to ensure that you return to what you love faster. Your joints and tissues are designed to function as a balanced system, and when dysfunction occurs, manual therapy can be a great way to begin restoring normal movement patterns.
Let’s use headaches as an example. During your evaluation, your therapist may identify areas of joint & tissue stiffness and associated areas of weakness. Based on their findings, the therapist would apply manual techniques to your spine to restore movement and decrease pain. Additionally, your therapist would apply manual exercise progressions to promote strength and stability in weakened areas. Your therapist can give you stretches to do all day long, but when the stretches are combined with manual techniques, you should have a quicker response and decreased headaches.
Examples of manual therapy techniques
Manual therapy is great for joints that are not moving or muscles that are extremely tight. For example, a hip flexor release is a common technique that loosens the muscle that runs from the front of the spine/pelvis down the thigh, or the hip flexor. This muscle may tighten while sitting for long periods of time, which can result in back pain. In order to get the most out of stretching the muscle, your therapist needs to manually release the muscle through soft tissue mobilization/massaging.
Manual therapy can also be very effective in treating shoulder pain. There are many conditions that can cause pain or reduced function in your shoulder, especially poor posture or overuse. Exercises can get you a long way, but manual joint & soft tissue techniques are needed to restore full range of motion.
Manual therapy vs. chiropractor vs. massage
Because manual therapy by a physical therapist involves a hands-on approach, many could confuse it with chiropractic care or massage therapy. But there are some critical differences between each practice.
Both physical therapists and chiropractors must attain clinical doctorates in their respective fields and must be licensed to practice by their governing boards. While physical therapists perform manual therapy techniques with the goal of establishing pain-free movement, chiropractors perform spinal adjustments primarily to treat underlying medical conditions and restore spinal alignment.
Chiropractors focus on issues stemming from spinal imbalances, such as back pain, neck pain, and headaches, and they may use specialized equipment in their practice. Physical therapists’ treatment expertise lies in restoring functional movement, decreasing pain, and preventing injury through manual techniques and prescribed exercises. They can practice in a hospital, in a hospice care setting, or in an outpatient clinic.
Massage therapists typically require a license from most states to practice, which requires a certain amount of clinical hours and an associated degree from an accredited massage therapy school, but there is no prior college degree required. Both massage therapists and physical therapists manipulate soft tissues and muscles, but the primary goal of a massage therapist is relaxation. Physical therapists, through their advanced education and clinical training, are licensed to use hands-on interventions in order to rehabilitate an injury or medical diagnosis.
Is manual therapy right for me?
While manual therapy can be an essential component of many physical therapy treatments, it may not be right for every patient. Medical conditions that require improving stability might need a treatment that does not involve manual therapy, such as joint hypermobility. Other conditions such as osteoporosis might not benefit from manual therapy due to lower bone density and the inherent risk of fracture. There are many other conditions that your therapist should be aware of before applying manual techniques.
Techniques are always applied with the intent of reducing pain and improving function. Treatments can range from gentle soft tissue mobilization/massage to reduce swelling, to increased pressure on specific joint structures to improve range of motion. If any technique is painful, your therapist should be able to adjust it so that you are not in any discomfort.
For example, if you have shoulder pain and loss of range of motion, your therapist may begin with gentle soft tissue techniques/massage to reduce pain and relax the shoulder muscles. Then, they might follow with a joint mobilization technique to improve range of motion and shoulder function. Your therapist should always be monitoring your tolerance to any technique. If you cannot relax during the treatment, your therapist will move toward a less painful technique.
On rare occasions, some patients are not as comfortable with being touched. Whether it is part of your personality or personal preference, your therapist will work with you and make sure you are comfortable while still getting the best possible treatment.
What will my treatment look like?
At EW Motion Therapy, all of our therapists are trained in manual therapy techniques, so we can incorporate them into your treatment and help you feel better. If you have more questions about manual therapy, fill out the Request an Appointment form on our website, and a member of our staff will contact you with the next steps.