Manual Therapy

Written by Jessica Wenzlaff, PT DPT

Many patients arrive at their first physical therapy appointment expecting to receive hot packs, ultrasound and instructions on how to complete a series of exercises. While exercise is definitely needed to improve the quality of overall movements and prevent pain from returning, exercise should be used as a complement to manual therapy. 

Manual therapy is a specialized form of physical therapy delivered with the hands as opposed to a device or machine. In manual therapy, therapists use their 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. Here at Sport & Spine Physical Therapy, we have a physical therapist who has completed a fellowship in manual therapy and a team of PTs who implement these techniques with patients regularly. Many of the conditions that therapist treat with manual therapy are not demonstrated with imaging or lab tests but rather during motion testing and a full movement assessment that is typically performed during the initial evaluation. 

Manual therapy techniques are aimed at relaxing tight muscles and restricted joints in order to decrease pain and increase flexibility. In general, manual therapy techniques employ the following types of movement:

  • Soft tissue work – including massage, which applies pressure to the soft tissues.
    • This pressure can help relax muscles, increase circulation, break up scar tissue, and ease pain in the soft tissues.
  • Mobilization/manipulation, which uses measured movements of varying speed.
    • These speeds range from low to fast, gentle to forceful, and distances (called ‘amplitude’) to twist, pull, or push bones and joints into position.
    • This can help loosen tight tissues around a joint, reduce pain in a joint and surrounding tissue, and help with flexibility and alignment.

While patients may be referred for physical therapy treatment by their primary care doctor, an orthopedic surgeon, or other doctor involved in their care, most states (including Minnesota) have direct access laws permitting patients to seek help for pain from a licensed physical therapist without having to seek a written referral.

Manual therapy can be helpful for the treatment of joints that lack adequate mobility and range of motion. These limitations can cause discomfort, pain, and an alteration in function, posture, and movement. Manual physical therapy involves restoring mobility to stiff joints and reducing muscle tension to return the patient to more natural movement without pain. Thus, manual physical therapy may provide pain relief both for patients with chronic back pain involving joint problems as well as acute back pain from soft tissue injuries such as a muscle strain. Most of the time, manual therapy is an excellent way to decrease pain that day, improve function, and allows individuals to return to their daily activities quickly. 

Manual therapy has helped many of our patients achieve their goal AND decreased the amount of time needed to fully recover from an injury. Contact us today to see if manual therapy may be beneficial for you! 507-474-6900.

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