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Manual Therapy Facilitates the Healing Process

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 manual therapists?

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 "integrated approach?"

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 therapy helpful?

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 and functionality.

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 physical therapy.

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