How your PT Can Use Manual Therapy to Improve Posture




Manual therapy is a valuable component of physical therapy, offering a hands-on approach to help patients improve their mobility and reduce pain. Physical therapists may use various techniques such as Functional Range Release, joint mobilizations, instrument-assisted soft tissue work, and manual resistance exercises to target specific areas of the body. Functional Range Release focuses on improving tissue quality and joint function, while joint mobilizations aim to restore normal joint movement. Manual resistance exercises help improve strength and coordination, aiding in overall rehabilitation.  Instrument-assisted techniques may be used to downregulate sensitive areas of soft tissue, or focus on surface layer of connective tissue.

These manual therapy techniques allow therapists to address individual patient needs and promote optimal recovery.  MOTIVNY therapists are trained on how to use these treatment tools as part of a comprehensive treatment program that includes manual therapy, exercise prescription, skill training, and objective feedback.  



A common misconception in manual therapy is that the harder the pressure, or more intense the sensation, the more it is working.  We greatly disagree with that sentiment in how we approach manual therapy.  While it may be tender and sensitive at times, MOTIVNY philosophy avoids being aggressive on inflamed or highly sensitive tissue.  Our approach aims to treat specific movement limitations with manual therapy that will aid the client in their improved practice of exercise or daily activities.  We assure that all soft tissue interventions and joint mobilizations are purpose-driven and connect with specific movement goals.

A good reason to employ manual therapy for a client may include stiffness in an area that individuals have a hard time moving or feeling on their own.  to achieve this, a therapist might employ specific soft tissue treatment, joint mobilizations, mobilization with movement, or other techniques, typically with the goal of specific input to a specific joint, muscle, or connective tissue.  

By contrast, a lot of therapists employ manual therapy because a muscle appears "tight."  At MOTIVNY we try to assess further to understand why a muscle is presenting as tight, and intervene on the underlying issue, rather than just smashing the soft tissue.  Oftentimes, a manual resistance exercise, isometric drill, or other movement with a specific input would be more effective to change the "tightness."  In Functional Range Release, the approach identifies the difference between mechanical tightness and neurological tightness, and seeks not to employ much soft tissue work when neurological tightness is present.



Imagine you are sitting on a chair and trying to twist your thoracic spine.  Are you sure you're actually moving your whole spine in a uniform way?  Likely the answer is no, as most people, especially in pain, have taken a habit of moving with specific strategies.  We may use manual therapy to help a client understand what parts are participating in moving, and what parts aren't, and connect that feeling with their exercise program to try to open up the potential for new movement strategies to be used.  Most of the time, we are poor observers of ourselves, and some clients will respond greatly to touch, and manual feedback in order to understand their tendencies.



When an area hasn't been in motion recently, the brain is receiving insufficient, or minimal feedback on how that joint or muscle is currently behaving.  Because of this, we may use manual therapy to help a client's brain improve the feedback loop from a specific area, and coach them on how to reproduce this on their own.  Additionally, input to that area may lead to new movement strategies when they perform their exercise.  Joint mobilizations, and manual overpressure or manual resistance can serve to coach the body out of a habitually used strategy and into something new.  This will lead to a new pattern of stress on the body, and potentially take pressure away from overworked areas.



When observing a person moving, or statically, posture should be considered a strategy the body is employing, often with the goal of conserving energy or avoiding pain.  If a portion of the body is unable to move, or isn't selected as part of a movement strategy, the body will remove that motion from its list of possible choices.  Over time, movement options are further restricted by this avoidance and can lead to strange positions that a lot of people call "bad posture."  As we use manual techniques, we're helping to collect information on what the body and brain perceive, and how it seeks to solve challenges.  Giving external inputs via manual therapy can help to re-open new possibilities for movement in the brain, and help to balance stress across alignment and broad soft tissue.



An aspect of manual therapy that most practitioners undervalue is its role in developing a common understanding with clients.  Frequently, I'll palpate (touch) a specific tissue, or mobilize a joint with the goal of understanding what exactly the sensation is like to the patient.  This includes a conversation about the degree and type of pain that someone experiences in a specific area.  If a client has 8/10 pain on touch of a specific structure, this will influence my decision-making on how to prescribe exercises or work with the client on their overall exercise program.

For example: A 35 year-old male started a marathon training program 8 weeks ago.  They arrive to Physical Therapy today after running 5 miles of recovery the day before, and complain of soreness in the quads and pain in the knees.  On palpation of the front of the shin, the client responds with a jolting reaction and 9/10 pain.  Given the schedule of activities, this would be somewhat unusual, and prompt the therapist to have a conversation about how activity schedule, intensity, and recovery are creating stress on certain areas.  We'll also use this opportunity to educate the in-season athlete on things to look out for in their upcoming weeks of training so that we can avoid increased potential for injury.



Being trained in touch, manual assessment, joint mobilizations, and soft-tissue techniques is a unique skillset of an experienced physical therapist.  While other professions can coach movement and exercise, this lens can often give a physical therapist a leg up in giving feedback to a client about what is happening in their body.  When we understand what motion is possible in specific joints, we can understand what strategies make sense for a client, and what tendencies they may have.  With this set of knowledge, and a strong coaching relationship, it is a key aspect of how we take a long-term approach to working with clients holistically.

Manual therapy



Manual Medicine, Kettlebells and Golf Training, Team Dad