Manual therapy is a treatment method used by athletic trainers, physical therapists and massage therapists. Generally, it is used to treat musculoskeletal pain and often includes joint manipulation, manipulation of muscles, kneading and joint mobilization. Within the physical therapy profession, physical therapy is a clinical approach to implementing hands-on techniques to increase the range of motion, treat joint structures, reduce pain, reduce inflammation and enhance healing. There are many different styles and methods of manual therapy used by physical therapists.
The Types of Manual Therapy
Often, patients are instructed to treat pulled muscles with rest and massage. These methods work well, but it is likely that the pain will return. That’s because the pain and muscle spasm are a result of a restricted joint. Joint mobilization used by physical therapists loosens up the restricted joint by applying slow velocity and increased amplitude. This type of manual therapy actually applies movement to the barrier of the joint. Joint mobilization is painless.
Soft tissue mobilization is used by physical therapists to break up fibrous muscle tissue and is often applied to the musculature surrounding the spine. This method of manual therapy entails rhythmic stretching and deep pressure. The therapist localizes the area of the greatest tissue restriction and begins to mobilize it with specific techniques, such as the Graston.
The high velocity, low amplitude thrusting technique is a more aggressive approach that entails taking a joint to its restrictive barrier and actually thrusting it. This technique is used for the restoration of joint motion and does not move a joint beyond its normal anatomical limit. Although it is a more aggressive type of manual therapy, it does not cause pain.
The strain-counterstrain method focuses on fixing abnormal neuromuscular reflexes that cause both postural and structural issues. The physical therapist will locate the patient’s position of comfort and hold that position for approximately 90 seconds. When holding, an asymptomatic strain is induced through stretching. The patient is then brought out of this position. This allows for a resetting of the muscles and sets the muscles for healing. It’s a gentle technique that is commonly used for back problems.
Muscle energy techniques (METs) are procedures used to lengthen shortened muscles and mobilize restricted joints. During this procedure, the patient’s muscles are voluntarily contracted against a controlled counterforce applied by the physical therapist from a specific direction. After the contraction, the joint is taken to its new barrier. This is an active procedure technique in which the patient participates and is well-tolerated.
How Manual Therapy in Physical Therapy Helps
Before any physical therapist initiates manual therapy, a full assessment of the blood and supply is done in addition to a muscle and bone assessment. The physical therapist will then implement the best type of manual therapy for the patient. All around, manual therapy increases blood flow, reduces pain, increases the range of motion and just plain feels good.
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