By Kerry McClure, PT, DPT, Methodist Hospital Therapy Services
Physical Therapy is the assessment and treatment of movement dysfunction,
which often involves relieving pain. Manual Therapy, the use of one's
hands to assess and treat musculoskeletal pain and dysfunction, has been
used in one form or another for 6,000 years. Physical Therapists, as well
as Osteopathic Physicians (DOs) and Chiropractors, currently practice
Manual Physical Therapy. With some similarities, each discipline has its
own approach, methods and terminology.
How is Manual Therapy used by Physical Therapists?
Manual Therapy as practiced by Physical Therapists is one of the best-kept
secrets in the medical profession since not all Physical Therapists utilize
this type of therapy. In addition, there are different Manual Therapy
systems/approaches within the discipline of Physical Therapy. Manual Physical
Therapy falls within two general categories: joint mobilization and soft
What is Joint Mobilization?
Joint Mobilization involves the movement of one bone in relation to another
bone in a joint, targeting accessory joint motion that is essential to
normal joint movement. Accessory movement happens without your consent.
For example, when you straighten your knee, your tibia (larger lower leg
bone) rotates outward to facilitate the extension/straightening. When
accessory joint movement is restricted, resulting in joint dysfunction,
Manual Therapy can restore normal joint movement.
What is Soft Tissue Mobilization?
Soft Tissue Mobilization involves techniques to decrease tension and pain
in the soft tissues. Along with accessory joint movement, soft tissue
strength and flexibility are essential to normal pain-free movement. When
restricted, it can result in a chronic pain disorder called Myofascial
Pain Syndrome. Soft Tissue Mobilization most often targets the muscle
(myo) and fascia, a network of tissue present throughout the body, which
organizes and supports all the structures in the body. Myofascial Release
involves gentle compressions and stretches to soft tissues that result
in relaxation of “trigger points.”
Do all Physical Therapy problems benefit from Manual Therapy?
Not all Physical Therapy problems benefit from Manual Therapy. Even in
cases where Manual Therapy is not needed as an intervention, a Manual
Therapist can provide a more thorough evaluation. Only a Manual Therapist
can identify and treat Manual Therapy problems.
About Kerry McClure, PT, DPT
Kerry McClure is a Manual Physical Therapist with 21 years experience
at Methodist Hospital
Therapy Services. He is certified in the “signs and symptoms” approach (a.k.a
the Maitland-Australian Method). For more information, contact Methodist
Hospital’s Therapy Services at 270-827-7593.