What is Manual Therapy?

Mary McMahon

Manual therapy is an approach to diagnosis and treatment of soft tissue and joint disorders that involves direct physical contact with the hands. The care provider uses physical touch to collect information that will inform the course of treatment and then applies various manual therapies with the hands in order to achieve treatment goals. A tradition of manual therapy exists in both alternative and conventional medicine, and a number of approaches to treatment involve direct physical contact with patients.

Massage is one type of manual therapy.
Massage is one type of manual therapy.

In manual therapy, the care provider can use a variety of techniques with the hands to manipulate tissues and mobilize joints. These include pressure, kneading, rolling, strain and counterstrain, gently bending and stretching, and a variety of other movements. As the care provider works, the patient can provide feedback about how it feels. In addition, the care provider may make observations about stiffness, apparent tenderness, and other symptoms identified during a manual therapy session.

A manual therapy session.
A manual therapy session.

In conventional medicine, physical therapy often integrates manual therapy. People recovering from surgeries and accidents can benefit from physical therapy sessions to improve joint strength, tone the muscles, and increase range of movement. It can also have psychological benefits, as demonstrated by studies on patients who receive massage as a supplement to other treatments.

Massage therapy is an example of manual therapy that can be used in alternative and complementary medicine. Massage therapists can utilize a variety of techniques including trigger point, deep tissue, craniosacral, hot rock, shiatsu, and myofascial release. Massage therapy can range from therapeutic massage that is simply designed to make someone feel good to sports massage, customized for athletes to help them develop strong, flexible muscles for competition.

Manual therapy can be suitable for the treatment of injuries to the soft tissue and joints, as well as being integrated into a recovery plan to help a patient become active and regain strength after an injury. It can be performed in hospitals, clinics, massage studios, or at home by a therapist who makes house calls.

Some forms of this type of therapy are widely accepted and integrated into conventional medical care. Insurance companies will usually cover manual therapy when it is prescribed by a doctor. Other techniques are less universally accepted and people may be required to pay out of pocket for these treatments. It is important in either case to work with someone who has received training and certification, as it is possible to cause injuries with this type of therapy.

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