What is Manual Therapy? 

Manual therapy refers to a wide range of hands-on techniques used by manual therapists to perform skilled movements aimed at managing pain, enhancing joint mobility, reducing or eliminating soft tissue swelling, inflammation, or restrictions, promoting relaxation, improving the flexibility of both contractile and non-contractile tissues, and enhancing pulmonary function. When appropriately combined with exercise, patient education, and other modalities this can be a powerful tool to address pain, functional loss, and wellness. The International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) describes orthopedic manual physical therapy as a specialized area for managing neuro-musculoskeletal conditions, emphasizing clinical reasoning and specific treatment approaches, including manual techniques and therapeutic exercises. Current research reveals that neurophysiologic mechanisms are at play and the beneficial psychological effects of providing hands-on examination and intervention have a strong effect in modulating pain.

What is the direction of the current research?

In a recent research article, “Unraveling the Mechanisms of Manual Therapy: Modeling an Approach,” experts hope that future research will aim to better explain and justify the mechanisms that contribute to pain inhibition during manual therapy. Unfortunately, there are so many complementary systems being affected during manual therapy making it challenging to narrow down what exactly is creating the specific therapeutic benefits from manual therapy. In the future, researchers would hope to create a more mechanistic-based approach to treating individuals presenting with musculoskeletal pain conditions so that a more targeted and personalized approach can be implemented in practice.

In practice, there are many notable manual therapy approaches that have been adopted by physical therapists and other hands on practitioners over the years who you may have heard of including the Cyriax approach looking at nonsurgical soft tissue lesions, Maitland utilizing passive/rhythmic mobilizations, Kaltenborn looking at translatory joint movements, Mckenzie using repeated or sustained movements to alleviate symptoms, and Lewitt using a combination of joint mobilizations and manipulation. Each approach emphasizes a tailored method to address dysfunctions in musculoskeletal health, integrating assessment, treatment, and patient education.

So how does functional manual therapy differ?

Here at Beacon Physical Therapy, we are trained in and practice Functional Manual Therapy® (FMT) which was developed by Gregg and Vicky Johnson, founders of the Institute of Physical Art (I.P.A.). FMT® uses specific evaluation techniques to identify movement dysfunctions that contribute to pain, decreased mobility and degenerative changes. FMT® is considered a systematic and scientifically-rooted full body approach, integrating all aspects of physical function, nutrition, and lifestyle education. This type of therapy has the potential to enhance your life in a way that not only eliminates pain, but allows you to discover your optimal state of physical performance and function by focusing on optimizing 3 main processes throughout therapy: mechanical capacity, neuromuscular function, and motor control.

Mechanical Capacity: Refers to the quality and excursion of movement and the ability to attain functional postures. This may include mobility of joints and soft tissues (such as skin, muscles, fascia, neuromuscular structures, viscera).

Neuromuscular function: The body’s neurophysiologic ability to initiate a muscle contraction with appropriate strength and endurance for any given functional task.

Motor Control: Refers to the ability to learn and perform voluntary movement patterns and postures with control and efficiency. This includes integration of sports specific movements, to everyday activities such as walking, lifting, active sitting, and other day to day activities.

By focusing on function, we can eliminate pain while also reducing the likelihood of its return. Unlike other manual therapy approaches, FMT® focuses on uncovering the root causes of your pain and limitations by taking a more comprehensive approach rather than directly addressing symptoms that often only see short term relief.

For a lengthy history of Functional Manual Therapy: https://ipa.physio/about-ipa-physio/

Sources:

Bialosky, J. E., Beneciuk, J. M., Bishop, M. D., Coronado, R. A., Penza, C. W., Simon, C. B., & George, S. Z. (2018). Unraveling the mechanisms of manual therapy: Modeling an approach. Journal of Orthopaedic & Sports Physical Therapy, 48(1), 8–18. https://doi.org/10.2519/jospt.2018.7476

Huijbregts PA. Manual therapy. InPain Procedures in Clinical Practice 2011 Jan 1 (pp. 573-596). Hanley & Belfus. Available from: https://www.sciencedirect.com/topics/medicine-and-dentistry/manual-therapy (last accessed 21.9.2019)

IFOMPT. OMPT Definition. Available from: https://www.ifompt.org/About+IFOMPT/OMPT+Definition.html (accessed 31 October 2024).

Johnson , G., & Johnson, V. (2018, April 4). Functional manual therapy. IPA Physio. https://ipa.physio/functional-manual-therapy/