What Is Manual Therapy?

By Ashley Simmons, DPT

Many people have gone to physical therapy and experienced exercise after exercise with redundancy and let’s be honest, often times very little guidance or supervision. Most often, patients are not even with the actual physical therapist. These experiences are far too common, and people don’t receive the full benefit of physical therapy if all they have done is exercise and maybe ultrasound or heat/ice. So, what is manual therapy and why is it important to the overall physical therapy approach?

Manual Therapy Is an Important Technique

There are many treatment techniques for therapists to use with their patients, based on the diagnosis and findings at the initial evaluation. One of the most important techniques used in physical therapy is manual therapy. Manual therapy is a treatment technique used for musculoskeletal conditions that involves manipulation of the muscles, joints, and tissues surrounding or supporting the area of focus. Your physical therapist should have extensive education in anatomy and the ability to impact change to the tissues which fundamentally assists in overall healing and the performance of the muscles and joints. A tight muscle is not going to be able to perform to the best of its ability. Think of a rubber band with a knot in it. Is it going to perform to the best of its ability? That is why manual therapy is necessary prior to performing all of those exercises.

Are Your Muscles in Knots?

Many conditions cause muscles to tighten abnormally causing pain, lack of range, or compensations elsewhere in the body. When muscle fibers are not properly lined up in parallel, they are often balled up in knots. Manual therapy is the most effective way to realign those fibers to allow for proper performance and recruitment of that muscle.

Physical Therapy Requires a Touch Approach

If you have been to physical therapy and the therapist did not touch you, then you have not been in real physical therapy. There is quite a bit of research to support that manual therapy has better outcomes on symptom management and functional improvements than exercise alone. If your therapist is not including this technique into their practice, you are likely not experiencing the maximum benefit. Manual therapy techniques can vary based on condition and provider. Examples of manual therapy are cupping, graston, soft tissue release/mobilization, trigger point release, myofascial release, joint mobilization, and joint manipulation, to name a few.