What is manual therapy?
Massage. Mobilisation. Manipulation. Dry needling. These are all examples of manual therapy- techniques that physiotherapists often use to address people’s symptoms. Chances are that you may feel better after receiving any of these techniques, however, it is important to understand manual therapy’s benefits and it’s limitations.
What does manual therapy actually do?
There is scientific evidence to show that due to complex mechanisms relating to how we think and feel, manual therapy can induce positive short-term effects within the body. We will likely have reduced pain and increased movement after receiving manual therapy (who doesn’t feel better after a massage?).
However, despite common beliefs, these are often temporary changes and do not permanently change the muscle or connective tissue structure. Studies have shown that it is very difficult to permanently change muscle or tendon structure, even with the most intense manual therapy techniques. It is a falsehood that it can permanently “re-align” your joints or lengthen your muscles or fascia.
Most importantly, whilst manual therapy can give great short term relief, it doesn’t address the ‘cause’ or the ‘why’, hence its short term results. To achieve a long-term effect from manual therapy, we would need to receive it again and again and again…
So when is it useful and how can we use it to our advantage?
How should manual therapy be delivered?
- As part of a broader treatment plan that addresses the cause/s of the problem e.g. targeted exercise, tips to manage symptoms at home
- To help give short term relief and improved movement to allow you to comfortably participate in your rehabilitation
- To help with the initial acute stage of problems/injuries and settle pain that is interrupting your sleep, work or the general day to day
- With transparency, it can be great, but isn’t going to solve your problem alone
How shouldn’t manual therapy be delivered?
- In isolation without other treatment (other than rare circumstances such as high levels of acute pain)
- With false information about how it affects tissue structure and pain
- In a way that creates an unhealthy long-term reliance on a therapist’s manual therapy to “fix” a problem or “maintain” a certain level of function
So to sum it all up. We use manual therapy everyday, it’s an important tool that can have a big impact in the short term. Every treatment tool has it’s place and understanding this ensures you get a long term, sustainable change to get you back to doing what you love, faster!
About the Author
This article was written by our Physiotherapist Pat.
Pat works with patients in clinic and Beaumaris Soccer Club making sure their Senior Mens and U21’s squads stay on the field. If you want to learn more about how we do Physiotherapy, read HERE.
If you have an injury or issue you want assessed by Pat or any of our other Physio team, book an appointment using the link at the top of this page!
References:
Konrad, A., & Tilp, M. (2014). Increased range of motion after static stretching is not due to changes in muscle and tendon structures. Clinical biomechanics (Bristol, Avon), 29(6), 636–642. https://doi.org/10.1016/j.clinbiomech.2014.04.013
Vardiman, J. P., Siedlik, J., Herda, T., Hawkins, W., Cooper, M., Graham, Z. A., Deckert, J., & Gallagher, P. (2015). Instrument-assisted soft tissue mobilization: effects on the properties of human plantar flexors. International journal of sports medicine, 36(3), 197–203. https://doi.org/10.1055/s-0034-1384543
Vigotsky, A. D., & Bruhns, R. P. (2015). The Role of Descending Modulation in Manual Therapy and Its Analgesic Implications: A Narrative Review. Pain research and treatment, 2015, 292805. https://doi.org/10.1155/2015/292805