What is Manual Therapy?

October 16, 2014 in STSMPT

Broadly speaking, there is a category of treatment provided by physical therapists called manual therapy.  Manual therapy can be very important to your physical therapy treatment plan, and there is a large and diverse body of research clearly demonstrating that adding manual therapies to your treatment plan often creates faster and better outcomes in treating injuries and chronic pain. When patients present with injuries or chronic pain, one of the many things specialized therapists will do is make an assessment of whether your treatment plan will get more efficient or better results with highly targeted manual therapies.


While there are multiple techniques in manual therapy, most manual therapy can be divided into three broad categories.


Soft-Tissue Mobilization: This is slow and controlled movement over soft tissues such as your muscles and fascia.  A massage could be considered soft-tissue mobilization.


Joint Mobilization: This is slowly coaxing the movement of joints.  Passively moving a joint through its physiological range of motion would be joint mobilization.


Joint Manipulation: This is a controlled, quick movement of a joint, often producing a clicking or popping sound.  In joint manipulation, your physical therapist may move the joint in ways that a person could not voluntarily move that exact joint through normal, controlled action on his or her own.


After manual therapy treatment, you will usually have less pain and freer, more flexible movement.  There may or may not be some mild treatment soreness.  Relief can be dramatic and long lasting, even after only one manual therapy treatment, but most often, people will need multiple manual therapy treatments as part of a comprehensive treatment plan spread over a span of time.


Safety: Complications from manual therapy are possible but extremely rare.  Some patients are aware that it is possible for manipulative treatment of the neck to contribute to a block of blood-flow to the brain or injury to the vertebral artery or nerves, but again, this is extremely rare.  In fact, it has been demonstrated that neck manipulation is safer than taking aspirin.(1)


The availability of mobilization and manipulation is one of the many reasons to see a physical therapist when you have been injured or are tolerating chronic pain.  This, along with a therapeutic exercise plan, ergonomic teaching, and other treatments can get you on a road to recovery that takes you farther and gets you there faster.


Dabbs, V, Lauretti WJ (1995). A Risk Assessment of Cervical Manipulation Vs. NSAIDS. J Manipulative Physiol Ther. 18 (8): 530-6.

Manual Therapy

Print Friendly