Not All Physical Therapy is alike . . . Manual Therapy is an Advance Post-Graduate Specialty

manual therapyA manual therapist is a specialist who utilizes skilled hands-on techniques to diagnose and “treat” their musculoskeletal conditions. Manual therapists have undergone many additional hours of advanced training in specific manual therapy techniques beyond traditional therapists. Manual therapists are more concerned about why a muscle or joint is not functioning properly and utilize exercise as a complement to manual therapy so patients become independent of pain.

What you need to know about manual physical therapy:

handsonIn 1994 the Agency for Health Care Policy and Research (AHCPR) released its recommendation for treatment of acute low back pain. Those recommendations were based on data published by the Quebec Task Force in the journal SPINE. The Quebec Task Force was a team of North American spine professionals, and their conclusions agree with the growing amount of literature that supports Manual Therapy is the premier method for the treatment of acute back and neck pain.

The Annals of Internal Medicine showed that in daily practice, manual therapy is a favorable treatment option for patients with neck pain compared with physical therapy or continued care by a general practitioner. Read The Abstract.

Hands-On” manual therapy techniques are performed with the goal of improving tissue extensibility, increasing range of motion, inducing relaxation, decreasing pain, reducing soft tissue inflammation, optimizing posture and improving function. While any physical therapist has the option to utilize manual therapy in their practice, many do not spend the time or the resources to become efficient in this area. Continuing education is more expensive, and though the average therapist knows a few manual therapy techniques, it is not the cornerstone of their treatment.

How do I know if I go to a manual therapy clinic?

You can identify a manual based therapy clinic by its focus. In a traditional clinic, modalities such as heat and electrical stimulation are emphasized and then you perform an exercise program which is the foundation of their recovery model. Absent, or performed inconsistently, are the skilled manual therapy techniques that require great amounts of practice, talent and experience to perform effectively.

Understand, most physicians do not know the difference and manual therapy is not commonly prescribed. Help us in educating your physician by requesting a referral to us for manual therapy, instead of just physical therapy. I would challenge you to experience the difference. We will give you a brochure for your physician so they can provide their other patients with scientifically supported options.

In a manual therapy clinic, “hands-on” techniques and evaluations are performed during practically every patient visit to reassess progress and determine why the pain or dysfunction is still present. The patient is then treated with hands-on techniques, followed by prescriptive exercises that support what the practitioner is trying to achieve through the skilled hands-on movements and techniques.

Some of the common manual therapy techniques we use are:

manual therapy neck treatmentSoft Tissue Mobilization (STM): Often muscle tension will interfere or inhibit normal joint motion and function. STM breaks the myofascial “adhesions” that may be caused by scar tissue, swelling, edema or spasms. Each layer of tissue is evaluated from the skin down to the muscle and areas of greatest resistance are released through various movements and pressures.

Strain-Counterstrain: A technique that corrects abnormal neuromuscular reflexes, often referred to as tender points, and many people call them trigger points. This technique is gentle enough to be used with patients that have acute, hot low back pain, to delicate to treat with other techniques.

Joint Mobilizations: Often muscle spasms are secondary to a restricted joint. Joint mobilizations loosen up restricted joints and increase its range of motion by providing slow and repetitive movements, to improve joint range of motion.met

Muscle Energy Techniques (MET): This technique is widely known to the osteopathic community, however, most DOs do not have the time to treat their patients with such techniques. If your primary physician is a DO, let him know this is one of the primary treatment techniques used in our facility by our manual therapists. MET is designed to mobilize restricted joints and lengthen shortened muscles. This is an active procedure with patient involvement where the patient is asked to perform specific resisted movements and muscle contractions, with guidance provided by their therapist.

Spinal Manipulation Technique (SMT): The goal of this procedure is to restore the gliding motion of joints, enabling them to open and close effectively. It is more aggressive than a joint mobilization or METs, and involves a single thrust type of movement into the restriction barrier of the joint. Increased range of motion along with decreased muscle tone is normally seen directly after SMT. If you are currently seeing a chiropractor, we work synergistically with them and we will provide you with prescriptive exercises to aid you in the recovery processes and promote healing as a team!

Dry Needling: Integrative Systemic Dry Needling (ISDN) is used for the treatment of soft tissue pain and dysfunction. ISDN technique is a modern Western medical modality that is not related to Traditional Chinese acupuncture. Dry needling has its own theoretical concepts, terminology, needling technique and clinical application. Learn more about dry needling.

prescriptive exercisesPrescriptive Exercises: Prescriptive exercises are prescribed to the patient to compliment the desired goal of the manual therapy technique applied. These are not to be confused to generalized therapeutic exercises, these exercises are very specific down to the joint level, and have a specific purpose and goal related to your manual therapy treatment.

Therapeutic Exercises: Maintaining long-term pain relief and optimal function is the goal, therefore, once the root cause of your dysfunction is treated through manual therapy, we design a therapeutic exercise program that promotes full recovery and wellness. Often referred to as core stability programs, back programs or functional exercise programs, these exercises are the core of traditional physical therapy.


Cupping: Also known as myofascial decompression therapy is a therapeutic modality in which a therapist puts special cups on your skin for a few minutes to create suction. People get it for many purposes, including to help with pain, inflammation, blood flow, relaxation and well-being, and as a type of deep-tissue massage.  Click here to read more.

Therapeutic Modalities: Modalities can be categorized into four general areas: cryotherapy (cold), thermotherapy (hot), electrotherapy, and mechanical modalities. This can range from icing, ice massage, ice baths, moist heat packs, hot water bath, ultrasound, TENS, dry needling, interferential current or neuromuscular re-education devices and traction devices. Our newest modality is our low level (cold) laser-electrical stimulation unit, click here to read about this cutting edge device.

Contact Us today to set up an appointment with a highly skilled manual therapist!