Manual Therapy

What is Manual Therapy?

More often than not, birth defects, aging, work-related injuries, car accidents, or simply poor structure or/and posture can lead to neck tension, back pain, or tension in many people. They are quite familiar with the debilitating discomfort that comes with the pain. When you want to return to a painless life, you often seek a physical therapist’s help for long-term relief.

Depending on the magnitude of your pain, therapists can recommend manual therapy. It’s a specialized physical therapy method, which integrates proper hands-on techniques sans the assistance of machines or devices. 

As per IFOMPT or the International Federation of Orthopedic Manipulative Physical Therapists, the definition of manual therapy is the production of Allor any of the effects, such as improving tissue extensibility, inducing relaxation, manipulating or mobilizing joints and soft tissues, modulating pain, changing muscle functionality, and reducing movement restriction, inflammation, and tissue swelling.

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Types of Manual Therapy

Before proceeding with manual therapy techniques, your therapist typically performs a complete and comprehensive assessment of your nerve supply, blood supply, muscles, and bones to ensure that there are no further complications. Depending on the examination results, the practitioner may choose to perform certain techniques.

  • Soft tissue mobilization:

Therapists often utilize this for breaking up muscle tissue fibers and relaxing muscle tensions. Your therapist may perform the procedure around the accumulation of scar tissue emanating from back injury.

  • Joint mobilization:

You implement this type of manual therapy for loosening a restricted joint and enhancing the rang of motion. It’s a painless technique that slows down the motion distance and speed.

  • Muscle energy techniques:

This procedure integrates voluntary muscle contraction against a specific counterforce for stretching shortened muscles and mobilizing joints.

  • The strain-counterstain technique corrects postural and edificial issues surfacing from abnormal neuromuscular reflexes. You need to gently perform the technique, which is why therapists may utilize it in place of other techniques that are too invasive intreating delicate or acute back problems.
  • Active release techniques:

A therapist show where adhesions come through touch.

  • Joint manipulation:

The practitioner applies a low amplitude, high velocity, and passive thrust to a joint complex. The thrust remains in its anatomical ambit. The main aim is to restore maximum function, motion and reduce pain.

Risks of Manual Therapy

Adverse effects of manual therapy are transient and common. It excludes spinal stretching or manipulation as they don’t affect the body. The most common pitfall is muscle soreness. Women patients report more detrimental effects than men. Muscle soreness leads to stiffness and pain.

Benefits of Manual Therapy

You often use manual therapy for issues emanating from the spinal cord, including chronic and acute back pain. However, you can implement the technique fortreating a wide range of issues.

  • Neck injuries, neck pain.
  • Hand, elbow, wrist, and shoulder problems.
  • Foot, ankle, knee, or hip problems.
  • Injuries stemming from accidents.
  • Workplace injuries
  • Muscle tension/spasms
  • You can cure neck pain like rib hypomobility, post-surgical neck pain, muscle     spasm, and disc pathology with the procedure.
  • Lower back pain includes spinal stenosis.

Manual Therapy for Conditions

You can use the technique for treating the thoracic spine. It’s also effective in treating hip bursitis, myofascial hip pain, hip impingement, and post-surgery hip replacements.

  • You can use manual therapy for treating knee pain like IT band tendonitis and knee replacements.
  • It’s also effective against ankle pain like ankle arthritis, chronic ankle pain, ankle sprains, and post-surgical pain.
  • Many therapists utilize the technique for treating impingement syndrome, frozen shoulder, and rotator cuff syndrome. 
  • Manual therapy can cure trigger points in muscles. 
  • Those with fused joints and ankle sprain can go for manual therapy.
  • If you have a Golfers’ Elbow and tennis elbow, manual therapy could be suitable for you.
  • People suffering from fibromyalgia and temporomandibular joint dysfunction can opt for manual therapy.

Who Shouldn’t Undergo Manual Therapy?

Manual therapy doesn’t have any absolute contraindications, but there are some conditions for which you need to take precautions. 

  • Skin infections
  • Open wound
  • Osteoporosis
  • Malignancy
  • Vertebral artery insufficiency
  • Hypermobility
  • Undiagnosed pain
  • Recent fracture

How to Prepare for Manual Therapy?

There’s a reason why all physical therapists don’t perform manual therapy procedures, despite all of them perform some type of manual therapy form at one time or the other. However, not every therapist uses the technique in a rehabilitation process. It takes years of hard work, skills, and hands-on training to be able to perform manual therapy.

The practitioners don’t have imaging assistant. It requires a special capability to discern the difference or anomalies in tissue consistency. In a nutshell, it takes time to master the combined sensory and motor skills for manual therapy.

What Happens Post Manual Therapy?

Spinal mobilization or manipulation is effective in adults. It’s effective in treating subacute, acute, and chronic low back pain. You also use manual therapy for treating cervicogenic and migraine headache, mobilization/manipulation, and cervicogenic dizziness.

  • For cervical mobilization or manipulation for neck pain, the evidence isn’t that inconclusive.
  • The mobilization and manipulation for tension-type headache, sciatica, and mid-back pain. 

Special manipulation is, however, not that effective for dysmenorrhea and asthma when you compare them to other techniques.

Related therapies

Neck pain needs traction or CPR, Clinical Prediction Rule. It identifies patients with chronic and acute neck pain. 

Massage is obviously another prominent therapy. It’s the genesis of physiotherapy. Posture, hand position, and physical contact are the main determinants of massage. 

Frequently Asked Questions

What are the different grades of manipulations?
Grading of manipulations or mobilizations is a very important aspect of manual therapy. Maitland Joint mobilization grading has five grades. The Kaltenborn traction grading includes three grades.
What are elbow mobilizations?
The elbow complex comprises humeroradial and humeroulnar joints. Elbow extension and flexion ensure a complete range of motion. Accessory movement of varus and valgus are essential.
Can manual therapy ensure hip mobilizations?
There are many manual techniques for increasing joint ROM and joint play of the hip complex. Hip mobilizations are also beneficial for people with hip osteoarthritis.

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