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How I Use Manual Therapy

Updated: May 5, 2022

What is Manual Therapy?

Manual therapy is a complicated topic in the online rehabilitation world. Most physical therapists are black-or-white all-or-nothing supporters or haters of manual therapy. Before we get too deep into things, a quick definition of manual therapy. It simply refers to any hands-on physical therapy including massage, stretching, joint mobilizations, and a bunch of other techniques. Some people argue that it is useless and a waste of time, others will say all you need is an experienced pair of hands to fix everyone’s aches and pains. Unsurprisingly, my answers are somewhere in the middle. I change my mind each day with every client that I see, so this is where I sit right now. I may revisit this again one day in the future as my opinions change, but this is my best shot at my understanding of manual therapy.

The first idea that we need to discuss is that manual therapy probably does not do what it is supposed to. Here is what I mean by that. If you get a massage, the massage therapist may talk about “breaking up trigger points” or “releasing your tight muscles”. This is not happening. Our bodies are really strong. It takes thousands of pounds of force to deform fascia by even 1% (I talked more about fascia in my plantar fasciitis blog here). If a massage therapist pushing on a muscle caused it to “release” then we would have died out a long time ago. Stepping on a Lego would actually kill you.

The same thoughts go into adjustments and manipulations. If your spine could be moved with a gentle push then we would have a lot of other problems. The crack you feel from a manipulation is probably a gas bubble that is popping. The rapid movement probably causes your muscles around the joint to relax. The truth is, we do not totally understand everything about the body and you should be wary of people who claim to know everything.

So, what does manual therapy actually do? I want to go over some benefits that it can have along with the probable reasons that they occur. As I mentioned before, this is simply where my thoughts are now and they could change tomorrow or next year.

Pain Relief

Pain is an important variable when it comes to physical therapy. It is not the only metric that we should use, as research shows that exercising with some pain may be necessary in certain cases. However, getting rid of pain can be helpful for everyone. Movements can be changed by pain and muscles can get stronger simpl