What is Manual Therapy, What are its Methods?

Manual therapy is a form of physiotherapy or physical therapy based on clinical judgment, using highly specific treatment approaches, including manual techniques and therapeutic exercises.

What is Manual Therapy?

Manual therapy, which is also accepted by medical authorities, is defined as an advanced specialty of manual physical therapy and is included in many medical sources as examination and treatment techniques integrated with exercise, client education and other physical therapy methods to address pain, loss of function and vitality. gets. 

Manual therapy is also applied in the light of available scientific and clinical evidence, taking into account the biopsycho-social conditions of each client. While investigating the causes of pain, limitation of movement and problems in the body, it also takes into account the physical, emotional, social and mental conditions of the people by acting in multiple directions.

Manual therapy is a physical therapy technique that is carried out by applying pressure to certain areas by hand. It exerts pressure on the muscles and connective tissue with emphasis on the hands, back and neurovascular system, and manipulates the joints to restore the body's functionality. The aim of manual therapy techniques is to address the causes of tissue and musculoskeletal pain and to eliminate these causes. 

What Does Manual Therapy Do?

Manual therapy by addressing the sources of pain and problems related to posture, muscle function or movement; 

• Helps improve mobility for stiff joints and muscles. 
• It helps to reduce muscle tension. 
• Provides solutions to manage a chronic condition such as back pain or joint problem. 
• It helps relieve headaches. 

Manual therapy helps relieve physical and neurological pain conditions by targeting soft tissues such as muscles, nerves and blood vessels or connective tissues such as tendons, ligaments, skin and fat. Manual therapy, which ensures the healthy and regular functioning of the blood circulation, supports the recovery of edema and lymphedema problems in the body. 

What are Manual Therapy Techniques?

Manual therapy should be applied by specialist physiotherapists and should be carried out together with exercises recommended by physiotherapists to support the recovery process after therapy. Three different techniques are used in manual therapy: biomechanical, psychological and physiological.

Taken as a whole, these techniques help loosen tight muscles around the back and joints to reduce the pain response and increase flexibility. When manual therapy techniques are handled one by one;

• To help heal and reshape tissues biomechanics, 
• For better pain management psychological and reduced voltage, 
• To increase mobility through stiffness and pain physiological techniques are applied. 

How are Manual Therapy Techniques Applied?

Before starting manual therapy practice, physiological ve psycho-social tests are applied. Physiological causes of pain and limitation of movement are determined by examining basic movements such as sitting, standing, walking and bending that people practice in daily life.

People who will receive manual therapy also psycho-social The difficulties encountered in work and family life and stress limits are discussed and barriers that may cause pain are determined. After the three-dimensional evaluation phase, it is determined in which areas and how the manual therapy techniques will be applied. 

Manual therapy techniques are divided into certain categories as follows;

Soft Tissue Application: It is the application of soft tissue techniques to muscle, tendon and nerve bundles. Soft tissue work involves the application of manual pressure to relieve tension, improve blood circulation, relieve inflammation and pain, and reduce scars and bands of fibrous muscle tissue. 

Mobilization and Manipulation:  Mobilization and manipulation practices that blend speed, strength and distance to restore mobility to bones and joints help reduce pain, increase joint flexibility, and aim to heal hard and tight tissues that restrict movement. 

Strain / Counter-Strain: Manual therapy method, also known as Positioning and Indirect Myofascial Relaxation, is used to treat pain and muscle spasm in acute injuries by targeting postural and other structural problems related to neuromuscular reflexes. Strain/Counter-Strain method, which is a frequently used method for chronic pain, by positioning the tissues in the most comfortable position; 

• It aims to heal the neurological system by interrupting the cycle of pain and spasm. 
• Relieves muscle spasm
• Improves the resting tone of tissues,
• Restores mobility improving function. 

Muscle Energy Techniques: It is based on the technique of developing a voluntary contraction against an opposing force to help reduce squat muscles and improve joint mobility. Muscle energy technique, which is a frequently used manual therapy method, mainly includes the following studies;

• Massage
• traction
• Trigger Point Therapy
• Passive and Assisted Range of Motion 
• Lymph Drainage (Lymph edema treatment)
• Soft tissue mobilization 
• Stretches that focus on the muscles, fascia, and joints 

In Which Situations Is Manual Therapy Applied?

Manual therapy is a hands-on approach used within a course of treatment to address muscle and soft tissue pain, joint stiffness, correct posture and assist with effective movement. Before starting the practice of manual therapy, the individual's injury or condition needs to be comprehensively evaluated with a holistic approach, including bones, muscles, and neurovascular conditions.

With the manual therapy programs created as a result of detailed examination and examination, the following problems are eliminated;

• Back and spine problems (Low back pain, Back hernia…)
• Neck pain (Neck hernia, neck flattening…)
• Hand and Wrist injuries (trigger finger, nerve compression, carpal tunnel syndrome…)
• Elbow and Shoulder problems (Frozen shoulder, tennis elbow, tendinitis…)
• Hip disorders (Hip instability, Arthritis, bursitis…)
• Knee disorders (Meniscus tear, patellofemoral pain syndrome…)
• Ankle and foot disorders (Foot swelling, Hallux valgus…)
• Injuries resulting from an accident 
• occupational injuries 
• Muscle tension and spasms 

What is the Difference Between Manual Therapy and Physical Therapy?

Manual therapy is a specialty in physical therapy. Traditional physiotheraphy methods focus more on managing and treating the symptoms of the disease process, manual therapy; focuses more on bio-mechanical, tissue-based examination to determine the cause of the disease process. Manual therapy is a highly successful therapy technique for the treatment of symptoms and problems that cause symptoms. 

Physiotherapy aims to strengthen muscles, improve balance, and increase mobilization by adopting an exercise-based approach. Manual therapy includes a hands-on approach such as stretching, joint mobilization, soft tissue relaxation, and helps the body regain its former range of motion by providing relief from pain and limitation of motion that causes pain.