Thursday Thoughts: The Simplification of Manual Therapy | Modern Manual Therapy Blog

Thursday Thoughts: The Simplification of Manual Therapy


Hi, my name is Erson, I am not a recovering manual therapist, I am a Modern Manual Therapist.

There is no need to present manual therapy as old hat, not needed, or wrought with placebo. While I agree with most of the assertions of many of these opinionated groups/individuals, it's all in the presentation. No need to be a jerk about it.

I am a classically trained manual therapist by a decent amount of con-ed, and in fellowship training. Here are things that took me a while to give up, but were liberating in the end

  • passive accessory/intervertebral motion testing
  • palpating for condition (warmth, tenderness)
  • palpation for structure
  • presenting manual therapy as a magical, completely necessary treatment that only those with magical hands can perform
Manual Therapy Misconceptions
  • you need to train for 1000s of hours to have the same results as a "master" manual therapist
  • you need to be able to feel the differences in vertebral movement to make your techniques more specific
  • you need (or are able) to be specific and target a specific motion segment or a particular tissue (fascia, nerve, capsule)
What "master" clinicians often have is not necessarily better hands, or psychomotor competence, but recognition of Clinical Practice Patterns. Only time and learning from your mistakes will improve this. Experienced clinicians often have more confidence, and are better able to interact with patients, answering their questions. This helps enhance patient expectation, thus improving outcomes.

How Manual Therapy should be presented
  • as a shortcut or entry into the nervous system
  • as having powerful, but transient effects the patient must maintain to have changes they want to last
  • as part of a test/re-test model that involves movements, asterisk signs, and movement patterns instead of passive accessory testing and special tests
  • able to be replicated by the patient at home with as similar a treatment as possible
Keeping it Eclectic....

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