WHAT IS MANUAL THERAPY?
A clinical approach utilizing skilled, specific hands-on techniques, including but not limited to manipulation/mobilization, used by the physical therapist to diagnose and treat soft tissues and joint structures for the purpose of modulating pain; increasing range of motion (ROM); reducing or eliminating soft tissue inflammation; inducing relaxation; improving contractile and non-contractile tissue repair, extensibility, and/or stability; facilitating movement; and improving function. 1,2 (Definition from American Academy of Orthopedic Manual Physical Therapy (AAOMPT) and American Physical Therapy Association (APTA).
WHEN IS MANUAL THERAPY USED?
Research coming out of Australia has demonstrated significantly better outcomes for patients who have a "multi-modal approach." This means when manual therapy is used in conjunction with other forms of therapy, such as exercise, proprioception training, etc., compared to manual therapy used alone. 6
Type of Manual Therapy we provide:
Mobilization:
The AAOMPT, APTA, and IFOMT (International Federation of Orthopedic Manual Therapy) define this as "a manual therapy technique comprised of a continuum of skilled passive movements to joints and/or related soft tissues that are applied at varying speeds and amplitudes, including a small amplitude/high velocity therapeutic movement." 7 It is described by Grieves 4 as "the attempt at restoration of full, painless joint function by rhythmic, repetitive, passive movements within the patient's tolerance and within the voluntary and accessory range, and graded according to examination findings." 1 Mobilization may affect a whole vertebral region or may be localized to a single segment. Manipulation is associated with a high velocity, low amplitude therapeutic movement. 1,2
SOFT TISSUE MOBILIZATION (STM) / MYOFASCIAL RELEASE (MFR)
STM: restoration of med/lat muscle play, breaking fascial restrictions between muscles and decreasing hypertonus that is associated with muscle tightness. Specific directional manual force is used in the direction of fascial restriction. Functional STM combines active lengthening of the muscle tissue with manual work at the same time.
MFR: similar to STM, but a larger area of tissue is targeted as opposed to very localized primary restrictions.
Research in the Netherlands has demonstrated cadaver dissection analysis of fascia to contain actin and myosin. If this research has validity, one could speculate fascia to be a contractile tissue instead of inert, connective tissue as previously theorized.
