What is Manual Therapy?
Manual therapy is an umbrella term which is used to describe a range of ‘hands-on’ techniques to various joints and muscles.
Korr (1978) described manual therapy as the “application of an accurately determined and specifically directed manual force to the body, in order to improve mobility in areas that are restricted; in joints, in connective tissues or in skeletal muscles.”
Manual therapy includes, but is not limited to:
– Spinal manipulation and mobilisation
– Peripheral manipulation and mobilisation
– Postural alignment
– Soft tissue release
– Deep friction massage
– Trigger point release
– Muscle energy techniques (MET)
Aims of Manual Therapy Treatment:
Manual therapy techniques is one component of nonsurgical management of the patient and is used to assist in the elimination or modulation of pain, to facilitate joint range of movement, progress tissue repair and improve function.
Research / Evidence for Manual Therapy:
Research has shown that manual therapy used as a treatment can produce significant mechanical and neurophysiological effects (Wright, 1995; Bialosky, 2009; Gross, 2010; Zusman, 2011), including the effects of pain relief, increasing range of motion and the influence on the autonomic nervous system.
Contraindications (When to Avoid Manual Therapy):
– Nerve route impingement where there is disturbance of bladder and bowel function, or perineal anaesthesia or Cauda equine symptoms.
– Patients with rheumatoid arthritis and osteoporosis are contraindications to forceful mobilisations.
– Any pathology leading to significant bone weakening such as tumours, infections, long-term corticosteroid medication, fracture.
– Patients with vertigo need close supervision
– Aortic aneurysm, bleeding into joints, e.g. severe Haemophilia
– Musculoskeletal deformity
– Spondylolysis, spondylolithesis
– Local discomfort (53%)
– Headache (12%)
– Tiredness (11%)
– Radiating discomfort (10%)