WHAT IS MANUAL THERAPY?
Manual physical therapy is a specialized form of physical therapy delivered with the hands as opposed to a device or machine. In manual therapy, we use our hands to put pressure on muscle tissue and manipulate joints in an attempt to decrease pain caused by muscle spasm, muscle tension, and joint dysfunction.
While all physical therapists have the option to use manual therapy in their practices, many don't spend the time or the resources to become efficient in this area of practice. At evolv, we have attended numerous post-graduate continuing education courses to refine and hone our skills, and are extremely proficient in using this as an intervention. Additionally, we are board certified Orthopedic Specialists (only a small number of physical therapist earn a specialty designation), which culminated months of study by passing a rigorous day long test.
HOW DOES MANUAL THERAPY WORK?
There are four main effects of manipulation that have been proposed: mechanical, neurophysiological, biochemical, and psychological.
Mechanically passive movement of a joint stretches the surrounding muscles, ligaments and the jointcapsule; it may also break adhesions or realign scar tissue, which leads to increased range of motion. These improvements are supported and maintained by having the patient perform specific exercises.
Neurophysiological mechanisms have been suggested in research literature. It is believed that manual therapy can have an inhibitory effect on pain systems in the spinal cord as well as at the site of injury.
Biochemical joint manipulation has also been shown to activate the endogenous opiate system, whichcan lead to a “natural high.”
Psychological hands-on treatment leaves patients confident in achieving positive outcomes from manual therapy; touching and manipulating injured tissues helps to validate the patient’s complaints of pain.
SHOULD YOU RECEIVE MANUAL THERAPY?
Any client with a painful or hypomobile joint meets the criteria to receive manual therapy. There are noabsolute contraindications to manual therapy; however there are numerous precautions. These includethe presence of disease, hemarthrosis, muscle holding, hypermobile joints, and joint replacements that the patient has not actively moved yet.
WHAT JOINTS CAN BE TREATED WITH MANUAL THERAPY?
There are no limitations to which joints can be manipulated or mobilized. Manual therapy is most known for its use on the spine. However, all joints may be treated, including the shoulder, elbow, wristand hand, sacroiliac joint, hip, knee, ankle, and toes.
Manual therapy also includes a wide variety of muscle energy techniques and specific exercises that reduce muscle spasm and guarding, and subsequently increase joint mobility.
WHAT IS THE EFFICACY OF MANUAL THERAPY?
Manual therapy has been shown to decrease pain and increase functional outcomes. Joint manipulation has been well-researched, and its efficacy published in numerous peer-reviewed journal articles, including Spine, Annals of Internal Medicine, Physical Therapy, Journal of Orthopaedic and Sports Physical Therapy, Cochrane Systematic Review, and many more.