Manual therapies include a broad range of physical treatments commonly used by physical therapists, massage therapists, chiropractors, and osteopaths. These therapies typically include massage and manipulation of muscles, as well as techniques to mobilize joints. According to Guide to Physical Therapy Practice, Manual therapy is defined as ‘skilled hand movements intended to improve tissue extensibility’.
When is manual therapy treatment required?
Manual therapy is used to treat motion impairments that cause pain and decreased range of motion. Joint-specific techniques are indicated when the motion impairment is caused by loss of the normal joint motion as a result of a reversible joint hypo-mobility. Manual therapy is typically contraindicated when the motion impairment is caused by excessive joint mobility. Motion impairment caused by weakened or shortened muscles is often an indication to use soft tissue techniques. Once pain has been reduced and joint mobility improved with the application of manual therapy, it is easier for a patient to regain normal movement patterns and restore maximal function. Manual therapy when combined with exercise techniques gives extremely positive results. This is extremely beneficial in cases of back pain and neck & shoulder pain.
Types of Manual Therapy:
Manual physical therapy is any highly skilled and specialized technique involving laying hands on a patient to effect change in a neuro-musculoskeletal condition. These techniques have been developed over centuries and honed through years of clinical reasoning, research, and evidence-based practice. Here are some types of manual therapies:
- Integrative Manual Therapy (IMT) – A holistic approach to physical therapy, IMT practitioners sense blockages in body systems and work to guide your tissues to clear those impairments and restore optimal function.
- Myofascial Release – Fascia is fibrous connective tissue surrounding muscles, vessels, and nerves, giving the body shape and form. Fascia is made up of densely packed bundles of collagen. Myofascial Release uses gentle, sustained pressure to mobilize connective tissue, relax contracted muscles, and increase blood and oxygen circulation to the tissues.
- Muscle Energy Technique (MET) – This technique involves using muscle’s own energy to release the tension and help it relax.
- Neural Tissue Tension Techniques – This technique is used to release any tension or adhesion to nerves, thereby restoring its optimal function.
- Positional Release Therapy – When you have a muscle spasm, or one of your muscles is too tight, too short or overactive, your therapist can put you in an optimal position for that muscle and guide you through relaxation and breathing while that muscle unwinds, softens and relaxes.
- Craniosacral Therapy – Craniosacral Therapy uses very gentle hands-on pressure to release tension and improve fluid flow, allowing your body to self-heal and calm the nervous system. This is beneficial in cases where membranes and fluid in brain and spinal cord dysfunction.
- Joint Mobilization – This therapy includes various movements to help ease the joint pain and discomfort.
- Medical Massage – Massage is the application of pressure to body tissues in a specific and rhythmic fashion. Massage techniques include kneading, rolling, edema, vibration etc. These help in reducing swelling, improving blood flow, improving lymph fluid flow, and stimulating healing and restoration of tissues.
- Manual Stretching – Various types of stretching exercises are performed to improve flexibility of the muscles.
- Proprioceptive Neuromuscular Facilitation (PNF) – PNF is a highly skilled and specific type and sequence of stretches. PNF works with the reflexes between the nerves, muscles, and brain to trigger the desired responses in muscle contraction and relaxation.
- Instrument-Assisted Soft Tissue Massage (IASTM) – This therapy is provided by trained therapists who use specific tools and instruments to provide pressure and treatment. It uses the body’s ability to heal itself in relieving the patient of their symptoms.
- Cupping Therapy – This therapy uses suction cups which are applied to the body to draw toxins and waste products out of the surrounding tissues and increase blood flow to the area.
- Dry Needling – Needling helps to stimulate blood flow to the area, increase oxygenation to the tissues, and reduce central sensitization. Needles are inserted in specific areas to trigger movement and blood flow in the muscles, which helps in its rejuvenation and repair.
The need of manual therapy in most cases is optional but optimal. The insurance has been slow to recognize manual therapy being done well as an effective treatment, but they are catching on. Remember, this practice is based on the science of spinal manipulation, which was born during the time when medicine was still in the dark ages and before there were antibiotics. In other words, while manual therapy is a powerful intervention that can be used at any stage in a patient’s treatment plan, agencies may decide not to use it in certain situations and still provide excellent care.
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