What is Manual Therapy?

You're fresh out of surgery and you arrive to physical therapy in your sling. You're not allowed to move your arm but your physical therapist is... 

This is what we call manual therapy.

It's when a physical therapist is doing any skilled intervention (treatment) with their hands.

There are 3 main reasons to do manual therapy:

Reduce Pain
Improve tissue tension
Improve mobility / range of motion

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These are all great to do at the early stages of treatment, meaning in your first few visits due to the higher level of pain you are experiencing. As your pain decreased we will transition you off of manual therapy and onto more functional based exercises. We broke down manual therapy into six different types:

1. Passive Range of Motion:
This is when a Physical Therapist is moving your limb through a motion and you are
totally relaxed, letting the therapist do all the work.

2. Joint Mobilization
This is when the Therapist will try to loosen a specific joint capsule, again with you the
patient being totally relaxed

3. STM or MFR
Soft tissue massage or Myofacial release are two types of “massages” to relieve tissue
tension.

4. Transverse friction massage
This is usually performed across a healed scar or over scar tissue in a “transverse”
direction to aid in breaking up scar tissue.

5. Strapping
A massage is done on a muscle while there is movement.

6. Effleurage
Primarily used to decrease swelling of the limbs in post surgical patients. This type of
manual therapy gently attempts to circulate the swelling back into the system.

Manual therapy is NOT what we would call instrument assisted therapy (IASTM). This type of therapy is when a Therapist uses tools (graston tools, cupping tools etc) to assist with the manual techniques.
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It is important to note that manual therapy is best used at the early stages of your treatment. As you progress it is vital to transition to more functional based activities and exercises. This helps you the patient regain independence and get back to living an active lifestyle!

By: Dr. Kyle Ioos, PT, DPT and Dr. Tony Tanzi, PT, DPT, CSCS

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