Manual Therapy Facilitates the Healing Process
By Michael Costello, M.S.P.T., M.T.C.
In recent years an increasing number of American physical therapists, like
their counterparts in Europe, Australia,
and New Zealand,
have acquired advanced training for certification in manual therapy. This is a
growing trend that recognizes the effectiveness of manual therapy in treating a
wide range of neuro-musculoskeletal problems.
Aren't all physical therapists also
In its broadest sense, manual therapy encompasses a number of therapeutic
disciplines that use hands-on techniques to make changes in the way the body
functions. Physical therapy, osteopathy, and chiropractic have been
historically considered different forms of manual therapy. Certainly all
physical therapists today receive basic training in joint mobilization, soft
tissue massage, and other manual therapy techniques.
More recently, the term “orthopedic manual physical therapy” refers to a
specific, integrated approach to healing, as well as the techniques used by
therapists schooled in this approach to treat problems in the joints, soft
tissues, and neuromuscular system.
What do you mean by an
Manual therapists treat both acute and long-term conditions. To facilitate
healing and gain comfortable mobility in injured joints, we use techniques
ranging from gentle stretching to thrust manipulation. For soft tissue injuries
affecting muscles, ligaments, tendons, and other myofascial
(connective) tissue, we employ a range of subtle to deep techniques, depending
on the exact nature of the problem and the individual we are treating.
When patients have problems with muscle coordination or body awareness, we
use hands-on neuromuscular retraining techniques. In this way we can guide the
muscles to activate correctly, either by facilitating normal movement or by
inhibiting inappropriate movement. A situation in which neuromuscular training
might be helpful is when a person with chronic neck and shoulder pain overuses
certain muscles in the neck and does not use lower muscles around the shoulder
blade. With neuromuscular retraining, this person can regain the ability to
raise his arm in the air using a more efficient and pain-free muscle pattern.
Manual therapy is an important component of a comprehensive treatment plan
that typically integrates hands-on techniques, exercise, and education. Some
patients benefit from more manual therapy and less exercise, while others
require more exercise than hands-on work. It's very individualized, depending
on the person, the injury, and his or her goals. And while the manual therapist
guides and facilitates the healing process, the patient must be willing to
enter into an interactive relationship and put forth the effort needed to heal.
For what types of conditions is manual
Manual therapy is helpful in treating almost any neuro-musculoskeletal
problem. People with acute neck and back pain, strains and sprains,
degenerative joint conditions, and myofascial
dysfunction such as fibromyalgia or myofascial pain
syndrome can derive substantial benefit from manual therapy techniques. When
muscle or soft tissue is tight or restricted, or when there is abnormal
movement or a decrease in coordination, manual therapy helps to encourage
correct movement that is also pain free. This enables the patient to work
toward normal functioning.
A manual therapist can often provide immediate relief for someone with a
joint that is stuck or caught up. For people with chronic pain problems, a manual
therapist can help them make incremental changes that "jump-start"
the healing process. Athletes who are coming back from injuries often seek out
manual therapists to help them regain broader range of motion that enables them
to perform well in their sport. In essence, manual therapists use their hands
in a number of ways to guide their patients' bodies toward pain-free mobility
Michael Costello is a physical
therapist and certified manual therapist on staff at Cayuga Medical
Center. He is enrolled at
Rocky Mountain University
of Health Professionals as a doctoral candidate in orthopedic and sports