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Everything You Need to Know About Manual Therapy

Pain can greatly interfere with a person’s quality of life. Whether you’re suffering from an injury or a medical condition, any form of physical discomfort can significantly affect your mood, mobility, sleeping patterns, memory and concentration, and even your relationships. Pain also tends to promote dependence on painkillers, making you more susceptible to anxiety and depression.

Chiropractic care involves using non-invasive techniques like physical therapy as an alternative treatment. The system of physical therapy is focused on the structure of the body to relieve pain and allow you to better manage your condition. Some patients take prescription medication for pain, but chiropractic care offers long-term relief minus the side effects.

Managing pain or discomfort is not as easy as it seems, especially if you don’t know its root causes. Let’s take a closer look at manual therapy as an alternative treatment for your pain.

What is Manual Therapy?

Also called hands-on physical therapy, manual therapy is one of the most widely used therapeutic solutions in the treatment of pain and musculoskeletal conditions. This specialized form of physical therapy is delivered with bare hands as opposed to a device or machine. Manual therapists perform skilled, specific hands-on techniques in an attempt to relieve pain caused by muscle spasms, muscle tension, and joint dysfunction.

Although clinical data and patient reports on manual therapy are limited, the practice is expected to grow as more clinical studies become available.

Manual physical therapy can be a helpful treatment for a wide range of issues or conditions, including:

    • Lower back pain – often a result of injuries, such as muscle strains or sprains due to heavy lifting, sudden movements, and poor body mechanics.
    • Hip pain – swelling, tenderness, and stiffness of the pelvic area.
  • Neck pain & stiffness – often a result of strain, poor posture, or osteoarthritis.
  • Tension headaches or migraines – a recurring type of headache characterized by a throbbing or pulsing feeling on the sides of the head
  • Shoulder impingement and elbow pain – also called tendonitis, this condition indicates a pinched nerve that causes pain in the front or the side of the shoulder and travels down to the elbow and forearm.
  • Patellofemoral syndrome or Knee Pain – also called a runner’s knee, this condition is common in people who engage in sports that involve jumping and running.
  • Ankle pain – tissue inflammation that runs across the heel bone to the ligament often caused by a strain injury.
  • Fibromyalgia – characterized by fatigue, sleeping problems, mental distress, and widespread pain all over the body.
  • Repetitive Stress Disorder – the gradual buildup of damage to nerves, tendons, and muscles from repetitive activities, awkward motion, and muscle fatigue.
  • Piriformis syndrome – characterized by the tightening and spasming of your piriformis muscle, a small muscle located deep in your buttocks that connects the lower portion of your spine to your thighbones.

Manual Physical Therapy Types

Manual physical therapy involves manipulating the joints to reduce pain, correct joint mechanics, and restore mobility. It also involves putting pressure on the soft tissues of the body to reduce muscle tension and inflammation, break up scar tissue, and increase circulation. Thus, manual therapy may provide relief for acute back pain from soft tissue injuries, as well as chronic back pain involving joint problems.

Some types of manual physical therapy include:

  • Spine Alignment – the therapeutic manipulation of the spinal column to protect the central nervous system and keep the body balanced and upright.
  • Back Alignment – the therapeutic manipulation of the backbone to improve posture and relieve pain in the lower back and upper back.
  • Hip Alignment – the therapeutic manipulation of the pelvic area to relieve hip pain, prevent injury, and treat vertical imbalance.
  • Tailbone Adjustment – the therapeutic manipulation of the coccyx to relieve pain and treat an injury from a fall, prolonged sitting, and childbirth.
  • Full Body Adjustment – the therapeutic manipulation of multiple joints to increase mobility, improve blood flow, and relieve pain throughout the body.
  • Massage Therapy – the use of compressed air and pulse massage patterns on the body to release tension, increase blood flow, relieve pain and soreness, and boost recovery especially for athletes, coaches, and trainers.

Manual Therapy Techniques

A bone and muscle assessment is usually performed before undergoing manual therapy or any type of physical therapy. Your practitioner may also conduct a full assessment of the blood and nerve supply in the affected area in order to decide whether or not there is a great risk of complications from the use of this pain management technique.

There are a wide variety of techniques that physical therapists use when caring for patients, and each technique has its own benefits. In general, manual therapy involves the application of the following physical therapist techniques:

Soft Tissue Techniques

  • Soft Tissue Mobilization (STM) / Myofascial Release (MYR)

Commonly applied to the muscles surrounding the spine, the soft tissue mobilization (SMT) technique consists of rhythmic stretching and deep pressure to break up myofascial adhesions or the fibrous and inelastic muscle tissues in the body. A layer-by-layer assessment will be conducted by your therapist to localize areas with great tissue restriction and mobilize them using a wide variety of techniques. This includes the placement of a traction force on the tight area in an attempt to relieve pain and restore normal texture to the affected tissue.

  • Strain-Counterstrain

The goal of strain-counterstrain is to correct abnormal neuromuscular reflexes that cause postural and structural problems, resulting in painful tender points. With this technique, your therapist will locate your position of comfort by asking you at what point the tenderness diminishes. You will then be held in your position of comfort for about 90 seconds, during which time asymptomatic strain will be induced through mild stretching. Your therapist will then slowly bring you out of the position, allowing your body to reset its muscles to a normal level of tension, which stages the healing process.

Joint Techniques

  • Joint Mobilization

Most patients rely on rest, massage, and hot and cold therapy as a quick-fix for a pulled muscle or a minor injury. While these remedies feel good, the pain often returns as the muscle spasm responds to a restricted joint. The joint mobilization technique aims to loosen up your restricted joint and restore optimal motion by moving your actual bone surfaces on each other in ways you cannot move the joint yourself. This painless procedure consists of a continuum of skilled passive movements to your joint complex that are applied at varying speeds and amplitudes.

  • Muscle Energy Techniques (METs)

Designed to lengthen shortened muscles and mobilize restricted joints, Muscle energy techniques (METs) use a voluntary contraction of your muscles against a distinctly controlled counterforce applied by your therapist from a precise position and in a specific direction. After a 3-5 second contraction, your therapist will take your joint to its new barrier where you will again perform a muscle contraction. This can be repeated two or more times. As opposed to mobilizations and other passive procedures, this technique is considered an active procedure since your therapist will not do all the work. In addition, METs do not stress the joint and are generally tolerated well by most patients.

  • High Velocity/Low Amplitude (HVLA) Thrust Techniques

Unlike joint mobilizations and muscle energy techniques, HVLA is a more aggressive technique that involves applying a passive, high velocity, low amplitude thrust to a joint complex but not past its restrictive barrier or anatomical limit. The intent is to restore the gliding motion of your joints and enable them to open and close effectively. When used properly, this technique will significantly decrease muscle tone and increase mobility. No structural damage takes place during the procedure and you should not feel an increase in pain following the treatment.

Manual Therapy Benefits

Manual therapy is a personalized form of treatment because it is customized according to your body’s specific needs and your individual condition. Unlike other aspects of physical therapy, the overall goal of manual therapy is to relieve pain and restore functionality through the use of natural body movements. Its hands-on approach allows for a combination of art and science to benefit each unique patient.

Here are some of the specific benefits that manual therapy techniques offer:

  • Reduced muscle tension – therapeutic massage reduces tension and promotes a relaxation response from muscles that are often spastic and tense due to stress, injury, and repetitive motion.
  • Increased blood flow – stimulating and manipulating tight or injured areas on your body helps deliver nutrient-rich blood that speeds up the healing process.
  • Improved flexibility and range of motion – applying gentle and precise movements help activate soft tissues and joints, restoring mobility and improving functionality.

For best results, manual therapy is often combined with other modes of treatment such as active stretching and progressive exercise.

Partner with LifeClinic for Your Recovery

Experience the difference of a hands-on approach to physical therapy when you partner with LifeClinic for your recovery. We combine the best manual therapy techniques with strength and stability exercises to relieve your pain and improve your quality of life. We also offer various physical therapy services aimed to restore, maintain, and optimize human function. Visit a LifeClinic location near you today. 

Dr. Reza Alizadeh

Dr. Reza is the visionary behind LifeClinic. His leadership is the foundation for the patient and team member experience, and overall direction of the LifeClinic. As the creator of IMJT, Dr. Reza continues to be the primary teacher on this technique.

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