Manual therapy, also known as manipulative therapy, is a physical treatment primarily used by chiropractors to treat musculoskeletal pain and debility.
This form of physical therapy takes a hands-on approach rather than using devices or machines. When a chiropractor uses their hands during manual therapy, they apply pressure on the muscle tissue and maneuver the joints in an effort to reduce pain associated with muscle tension, muscle spasm and joint dysfunction.
When a person has insufficient movement and range of motion in their joints, it can lead to pain, discomfort and an interruption in function, movement and posture.
By implementing manual therapy, the following can occur:
There are many manual therapy techniques, and, as a group, they aim to relax tense muscles and ease restricted joints. Overall, however, these procedures exercise three main types of movement:
Mobilization and manipulation are often talked about together. They use calculated movements of various speeds (slow to fast), force (moderate to strong) and distances to pull, rotate or thrust joints and bones into position to help release stiff tissues around the joint, minimize joint pain, reestablish alignment and assist with flexibility.
Prior to executing manual therapy, the chiropractor will typically do an assessment of the nerve and blood supply in the treatment area, as well as look at the bone and muscles themselves. This helps him or her determine whether this physical therapy is appropriate for the patient’s needs. Contingent on the assessment, the chiropractor may perform one or more of the following manual therapy techniques:
Please contact your chiropractor with any questions.
Forceful spinal manipulation is not always necessary to treat conditions of the lower back, mid-back and neck. Gentle chiropractic treatment, such as drop table techniques, involves less powerful spinal maneuvering and slower, low-velocity movements that allow the affected joint to stay within its passive range of motion.
Also known as the Thompson technique, the “drop” approach uses a special chiropractic table. The table used has segments that can be lifted up and then dropped when a thrust is applied by the chiropractor. The drop allows gravity to assist and work in combination with the manual adjustment, and all of this provides a lighter adjustment than that which comes with some other chiropractic techniques, such as those that involve twisting positions.
To further clarify, the table has various sections that are raised between 1 to 2 inches relative to the rest of the patient’s body. Once the section of the table is lifted, it is fastened in place and the stiffness of the table is altered based on the patient’s body weight. When the chiropractor applies a gentle thrust to the area needing adjustment, the table releases and drops down, causing that segment of the body to fall too. The drop table comes to a rest, but the patient’s body momentum continues for a short period. This momentum is equally as critical to the drop table technique as the thrust and dropping of the table are, because it aids in alignment.
The number of sessions needed depends on the type of condition the patient has and its severity. However, in general, the patient should have better range of motion and less pain with each treatment.
To learn more about the drop table technique and how it can help, contact your chiropractor.
When there is damage to muscles and other soft tissues including pulls, tears, or not being able to get enough oxygen (hypoxia), it can result in the body producing rough, thick scar tissue in the affected area.
Scar tissue restricts the tissues from moving freely because they bind them and tie them down, and as scar tissue builds up, muscles shorten and become weaker, nerves become ensnared and tendinitis can develop due to tension on the tendons. This can lead to reduced range of motion, pain and loss of muscle strength. Should a nerve become trapped, the person may additionally experience numbness, tingling and weakness.
Active release techniques (ART) attempt to address problems in individual tissues, since one tissue or structure can affect another structure both directly and biomechanically. With this method, the chiropractor identifies problems with movement, pressure and stiffness between the nearby tissues, and then addresses them.
While scar tissue and muscle tension can be addressed with massage, electrical modalities and applying pressure to trigger points, ART seek to take a different approach. It is not just about treatment; it’s also about understanding the muscles and how they have been affected.
After the chiropractor has gotten a feel of the tissues and their texture, motion and tension, he is able to understand and assess the motion of each tissue relative to the one adjacent to it. Now equipped with this knowledge, he can determine whether to:
By doing one or more these, movement can be restored; fibrous adhesions can be broken down; trapped nerves or blood vessels can be released; pain can be reduced; and oxygen and blood can be efficiently delivered to the muscles and tissues.
There are more than 500 specific moves associated with ART, and each allows the chiropractor to recognize and rectify problems that affect each individual patient. For this, ART do not take a cookie-cutter approach, nor do they only treat problems with muscles. In addition, these “soft tissue system/movement-based massage techniques” treat tendons, ligaments, fascia and nerves.
However, unlike massage, the patient does not lie motionless, and neither pressure nor movement is lateral to the muscles, nerves, ligaments and tendons. Instead, ART use longitudinal movements, and they require the patient to be both a participant and non-participant in their care. In some levels of treatment, movement of the patient’s tissue is done by the chiropractor. In other levels, the patient must actively move the affected tissue in a specific way while the chiropractor employs tension. So, in many ways ART are not strictly a massage; instead, they are a form of manipulation.
Because the muscles and other soft tissues can be manipulated, a variety of conditions — all of which are typically the result of overused or overworked muscles — can be resolved with this technique:
Please contact your chiropractor if you have any questions about ART.
