It's a physical therapy paradox in today's health care market due to insurance reimbursement. Over the past decade, more and more research has demonstrated how manual therapy treatment approaches performed by physical therapists enhance the outcomes for a broad range of conditions.
Physical Therapists utilize manual therapy to treat back pain, shoulder impingement syndrome (e.g. Frozen Shoulder or Rotator Cuff injuries), headaches, Carpal Tunnel Syndrome, neck pain, sports injuries, Fibromyalgia, etc. Over this same span of time, many physical therapy clinics have deemphasized manual therapies, opting to utilize profitable approaches requiring less on-on-one time.
When choosing a physical therapist for your recovery from surgery, a sports related injury or work injury determine if the physical therapist you are referred to or selecting utilizes manual therapy as part of their rehabilitation approach.
What is Manual Therapy?
The term manual therapy performed by a physical therapist refers to a host of approaches wherin the physical therapist uses his or her hands to achieve specific motion in targeted joints and/or soft tissue to improve or restore proper biomechanical motion. A physical therapist who utilizes manual therapy also may include higher velocity thrusts for greater mobilization of a restricted joint due to scar tissue, stiffness or soft tissue restrictions.
Manual therapy also provides the benefit of stimulating mechanoreceptors which are positive nerve stimuli in the joint and assist in reducing nocioceptor information or inappropriate nerve pain stimuli. The mechanical benefits include stretching joint capsule tissue, tendons and ligaments to overcome what is termed hypomobiity (restricted motion).
In general a physical therapist uses manual therapy to focus on healing injured tissue through the effects of motion. WIth manual therapy, a physical therapist can introduce therapeutic motion to tissues or joints much faster than would be possible through voluntary motion alone.
A physical therapist who combines motion manual therapy with therapeutic exercise, functional movment and medical therapeutic equipment on a regular treatment basis will improve and increase a patient's recovery faster than without utilizing this specialized approach.
As you select a physical therapist you should inquire about their level of specialized training and ascertain if they are a skilled manual therapist?
Physical Therapy Research & Guidelines:
Peer review journals and current guidelines show the benefits of manual therapy performed by skilled physical therapists in the treatment of back pain, headaches, sports injuries, carpal tunnel syndrome, Fibromyalgia and more.
One study by Bang et al reported in the 2000 Journal of Orthopaedic and Sports Physical Therapy compared two treatment approaches for shoulder impingement syndrome. The first treatment approach was physical therapy directed strengthening and stretching exercises. The second type of physical therapy provided the same exercises plus passive joint mobilizations involving skilled manual therapy applied by a physical therapist. While both groups showed significant improvements in only three weeks, the group receiving manual therapy reported twice the pain decrease on a visual analog scale and more than twice the improvement on functional ability questionnaires. The researchers demonstrated that even when exercise, stretching and other voluntary movements are effective, manual therapy provided by a physical therapist can significantly shorten a patient's recovery time.
Another good example reported in the 1999 New England Journal of Medicine by researchers Anderson et al., concluded that there was more effectiveness of adding manual therapy to reduce a patient's low back pain. In the study, group one received a standard therapy approach including anti-inflammatory medications, muscle relaxants, ultrasound, heat & cold packs, and electrical stimulation provided by a physcical therapist.
In the second group, patients received the same treatment for low back pain and also received manual therapy techniques provided by a physical therapist. Both groups showed improvement in a reduction of pain, but the patients receiving manual therapy from the physical therapist had less than half the need for pain medication and 75% less muscle relaxant usage.
This study demonstrated that manual therapy provied by a qualified physical therapist can positively affect treatment outcomes even when added to a treatment plan including pharmacological therapies and therapeutic modalities.
In conclusion, when selecting a physical therapist to assist you with recovering from an injury determine their level of clincial expertise and if they have specialized training in manual therapy and the amount of time allowed for its use in your physical therapy appointment.
Gary Maguire, PT
Key Words:
Gary J. Maguire, PT, Physical Therapist, Vancouver, WA, Pain, Manual Therapy, Low Back Pain, Fibromyalgia, Sports, Medicine, Physical, Therapist, stretching,Chosing the Right Physical Therapist to Help You with Your Rehabilitation by Gary J. Maguire, PT: Physical Therapist
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