What’s Manual Therapy?

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This is a fairly common question. Professionals in the field have always wanted a short and precise answer; without either over simplifying the answer, presenting an incomplete view or worse, substituting it with another equally difficult or vague term. But nevertheless, it is important enough for us to try to define manual therapy.

Manual Therapy For Musculoskeletal Conditions

Manual Therapy is an area of manual medicine treating musculoskeletal conditions. These are conditions related to the muscles, bones, joints, connective tissues such as tendons and ligaments, spinal discs and the nervous system that enables them to all work together. Manual therapy covers a broad range of techniques. It is perhaps easiest to define it as an approach not based on the use of electrical and/or electronic devices. Examples include traction machines, TEN, EMG and shortwave diathermy machines.

As with most other areas of specialties, there are two broad areas of manual therapy. These are the techniques and the critical diagnostic analysis.

Manual Techniques

First, there are the techniques. These can range from myofascial trigger point release of tight muscles, spinal manipulation or mobilization to release tight joints, and neuromuscular retraining correct the muscle activation pattern. It can also include sports taping to provide support to joints to something more basic like deep tissue massage. Manual therapy is not technique specific but rather includes a very broad range of techniques to enable proper musculoskeletal functioning. This area is the most visible area and perhaps most familiar to the general public.

Critical Diagnostic Analysis

It is the second area that manual therapy comes into its own – critical diagnostic analysis. Determining what is the immediate cause of the pain is often straight forward, such as a muscle strain in the back or a nerve impingement in the lumbar spine. Treatment in such cases using TENS machine on the area of pain or traction is simple, and can be effective to address the immediate pain. However, these treatments usually have no lasting effect. This is because they do not address the 2nd or higher level causes of pain. It is like driving a car with a leaking radiator. The car overheats when there is no water in the radiator. Filling up the radiator solves the immediate overheating problem. But if the leak continues, the radiator will soon empty again and cause the engine to overheat.

So a manual therapist must probe further, “Why is the muscle strained?” Because of the musculoskeletal system in the human body are all interconnected, answers can sometimes be found rather far away from the pain site and not immediately intuitive. Here is an interesting case study – Mal-Aligned Rib.

Manual therapists usually work with a team of massage therapists and sports rehabilitation trainers to assist with the manual treatment and exercise rehabilitation once the root cause of the problem is diagnosed.