Physiotherapists restore normal movement of joints and soft tissue by using manual therapy – specific hand placements and precise application of forces. It has been shown to decrease pain and increase functional outcomes. It has been well-researched, and its efficacy published in numerous medical journals.
What is manual therapy?
Manual therapy is defined as the skilled passive movement of joints and soft tissue Physiotherapists are concerned with normalising specific motions that take place between joint surfaces that enable normal joint mobility It is important to note that Manual therapy is used in conjunction with other physiotherapy techniques for instance, exercises and modalities such as ultrasound.
How does manual therapy work?
There are four main effects of manipulation that have been proposed: mechanical, neurophysiological, biochemical, and psychological.
Mechanically, passive movement of a joint stretches the surrounding muscles, ligaments and the joint capsule; it may also break adhesions or realign scar tissue, which leads to increased range of motion. These improvements are supported and maintained by having the patient perform specific exercises.
Neurophysiological mechanisms have been suggested in research literature. It is believed that manual therapy can have an inhibitory effect on pain systems in the spinal cord as well as at the site of injury.
Biochemically, joint manipulation has also been shown to activate the endogenous opiate system, which can lead to a “natural high.”
Psychologically, hands-on treatment leaves patients confident in achieving positive outcomes from manual therapy; touching and manipulating injured tissues helps to validate the patient’s complaints of pain.
Who should receive manual therapy?
Anyone with a painful or hypomobile joint meets the criteria to receive manual therapy. There are no absolute contraindications to manual therapy; however there are some precautions. These include the presence of disease, hemarthrosis (bleeding into the joint space) muscle holding, hypermobile joints, and joint replacements that the patient has not actively moved yet.
Which joints can be treated with manual therapy?
There are no limitations to which joints can be manipulated or mobilized. Manual therapy is most known for its use on the spine. However, all joints may be treated, including the shoulder, elbow, wrist and hand, sacroiliac joint, hip, knee, ankle, and toes.
Manual therapy includes a variety of physiotherapeutic treatment techniques.
It can decrease pain and help to increase functional movement. Manual Therapy is normally used in conjunction with other physiotherapy techniques such as exercise and electrotherapy.