Manual Therapy

Manual therapy may be successful where other more generic therapy treatments have failed. When an acute injury does not heal properly, it can leave a patient with chronic pain. Chronic pain is defined as pain lasting for 6 months or longer. Often a patient with chronic pain has received various treatments with the hope to control their pain. Manual therapy is especially helpful for chronic pain as it tries to direct the treatment at the source (cause) of the pain. This is a hands – on (manual) approach to the assessment and treatment of certain kinds of physical conditions that affect muscles, joints, nerves and fascia.

Manual therapy is a general term for therapy treatments that are hands on. The therapist is applying specialized treatments individualized for the patient typically through the therapist’s hands. This includes but is not limited to joint mobilizations, muscle energy techniques and manipulations, myofascial release, soft tissue mobilization, and muscle re-education.   Manual therapy can be used for any age range to decrease pain and improve function of chronic pain, acute pain, various muscle skeletal (orthopedic) conditions, neurological conditions, and athletic injuries. Manual techniques should be used in conjunction with exercises to give the greatest results.

Joint mobilizations are a form of manual therapy. For numerous and various reasons a joint can move incorrectly. Joint mobilizations try to increase the lubrication, nutrition, and restore proper mechanics of the joint. Once a joint can move with greater ease, it can allow muscles to stop guarding and relax.

Muscle energy techniques and manipulations of the spine are the terms used to correct spinal mechanics. It works the same way as joint mobilizations.

Myofascial release is a way to decrease pain by breaking up scar tissue. The body heals through producing scar tissue. Scar tissue is good unless the scaring process goes on too long. When something has not healed properly, it will keep laying down more and more scar tissue. This can compress the nerves around an area creating pain. Myofascial release tries to reorganize the scar tissue causing changes in the fluid around tissues, so that the tissue will not compress the nerves as much.

Soft Tissue mobilization tries to release the knots in the muscles. Some people refer to this as a deep tissue massage, or trigger point releases.

Once the joints and soft tissue are working properly, it is time to re-educate a muscle. Muscle re-education are exercises that will help the muscle function the way it is supposed to work.  Some people may be strong but they lack the endurance needed for a task. While others may lack stability, or the muscle may stay in a contracted shortened state. There are different techniques and exercises to restore the natural way the muscle was meant to function.

Not all therapy is the same, certified manual therapists require advanced levels of training. Most patients will significantly improve with this more advanced form of therapy. You will need a doctor’s prescription to come to therapy (and for insurance to approve), and let your doctor know if you would like a certified manual therapist. If you have any questions please call the phone number or by above e-mail.


Brian Stisser PT, CIMT


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