What is manual therapy? That really is a loaded question. Different professionals interpret the term to define legal parameters of their practice. In the most encompassing terms it simply means the use of a practitioner’s hands to affect change in a patient. Many professionals use manual techniques, including physical therapists, osteopaths, chiropractors, massage therapists, athletic trainers and others. In its most basic form, it has been used for healing since the dawn of man.
Physical Therapists have a unique education and perspective in the use of manual therapy.
During formal training, physical therapists are taught to diagnose joint and movement problems by differentiating the structures that are involved. That could be as simple as performing a manual test to determine if the ACL ligament in the knee has been torn; or as complicated as determining the structure that is responsible for the limited shoulder motion. Limits to shoulder motion and most joint movement problems can be caused by a myriad of issues including neurologic pathology, muscle shortening, ligamentous or tendon problems, bone spurs, pain, weakness, cartilage issues or joint capsule restrictions just to name a few.
There are countless manual therapy techniques with catchy names and different uses. There are even forms that offer practitioners certifications in a particular technique. You may see these listed as Trigger Point Release, Proprioceptive Neuromuscular Facilitation, Muscle Energy Technique, Strain-Counterstrain, Active Release Technique, Cranio-Sacral Therapy, Myofascial Release and others. Although these techniques can be helpful and useful, there is no evidence that any of them is the only way or even the best way to treat a particular problem.
Physical therapists are experts at determining the cause of the movement dysfunction. The capable hand of a physical therapist, for instance, can detect the difference between a capsule restricting motion and a trigger point in a muscle restricting motion. A skilled and experienced physical therapist choosing the most appropriate form of manual therapy to affect the change needed will get the results you want.
Natalie Conway is a Physical Therapist and Regional Director for Tidewater Physical Therapy, Inc.’s Gloucester Region, which includes two out-patient clinics and a performance center. She is a board certified Orthopedic Specialist (OCS) and certified athletic trainer (ATC).
Many of the physical therapists at Tidewater Physical Therapy Inc. hold Direct Access Certification through the Virginia Board of Physical Therapy.
Natalie holds Direct Access Certification and is available to evaluate and treat patients without a prescription from a physician.