What is Manual Therapy?
Manual therapy is a set of hands-on applications performed by a specialist physician without the need for any devices, based on a detailed evaluation, particularly for musculoskeletal system problems.
There are various approaches, including Osteopathic Manual Therapy, the Mulligan Concept, the McKenzie Concept, Chiropractic Care, and the Fascial Distortion Model. A correct evaluation and goal-oriented application significantly increase the success rate.
Session intervals vary between 3 to 7 days, depending on the individual and the type of application performed. As the severity of symptoms decreases, the session intervals can be extended. Just as degeneration does not occur in a single day, recovery cannot be expected in just one session. Healing is a process.
Manual therapy can quickly relieve pain or address a problem, but full recovery cannot be achieved without ongoing support. It is essential to continue with an exercise program that complements the treatment. Periodic check-ups and exercise adjustments are beneficial for optimal recovery. This process must be managed effectively through collaboration between the physician, therapist, and patient.
What Are the Applications?
Following a thorough evaluation, the specialist determines which tissue requires treatment and what techniques should be used. Various applications include:
- Myofascial release
- Mobilization
- Manipulation
- Friction techniques
- Trigger point therapy
- Cupping therapy
- Classical massage
- Connective tissue massage
- Functional massage
- Taping
Since manipulation videos are quite popular, it is important to note that manipulation is just one component of manual therapy. It is not suitable for everyone. Before application, a thorough evaluation should be conducted, considering factors such as the patient’s age, presence of rheumatic diseases, pregnancy status, and long-term medication use. The decision should be made by a specialist physician.
At the end of each session, patients are taught exercises that support the treatment, which accelerates and completes the healing process. Nutrition, alcohol and tobacco consumption, and stress management also play crucial roles in recovery. Patients should be guided accordingly.
Who Can Benefit from Manual Therapy?
It is easier to explain who should not receive manual therapy. It should be avoided in cases of fractures, the presence of tumors, and severe nerve compressions with significant loss of strength.
There are also individuals who require special attention, such as:
- The elderly
- Children
- Pregnant women
- Individuals with rheumatic diseases
- Those who have used corticosteroids for a long time
- Patients with advanced osteoporosis
Not all applications are suitable for these groups, and caution must be exercised.
Manual therapy can be safely and effectively applied in the treatment of:
- Herniated discs
- Mechanical low back pain
- Headaches and migraines
- Cervical straightening
- Cervical herniation
- Nerve compression
- Fibromyalgia
- Muscle tears
- Joint problems (knee, hip, elbow, shoulder, wrist, ankle, iliac-sacral joint)
- Frozen shoulder
- Heel spurs
- Scoliosis
- Fascial tightness
- Carpal tunnel syndrome
- Meniscus lesions
- Ligament injuries
- Limitations due to immobilization after fractures
In cases of common disc herniation, manual therapy combined with an exercise program is highly effective. Contrary to popular belief, herniated discs are not permanent conditions; they can heal over time.
Additionally, manual therapy can be beneficial for pregnant women experiencing lower back pain, muscle spasms, pelvic floor problems in women, and neurological conditions.
Does Pain Return After Manual Therapy?
For pain not to return, complete tissue healing must occur. The key factor here is not just the disappearance of pain. When the pain subsides, healing has begun, but it is not yet complete. At this stage, the new tissue formed is weaker. To ensure it transforms into strong and healthy tissue, the necessary stimuli must be provided.
If proper healing does not occur, any minor strain or trauma can cause re-injury, restarting the process from the beginning. To achieve full recovery, patients must engage in regular exercise, maintain a balanced diet, and manage stress effectively.
Each type of tissue requires different stimuli. While connective tissue benefits from stretching, cartilage tissue requires compression. Therefore, exercise programs should be tailored to the individual and the affected tissue, rather than relying on standardized exercise routines.
With the right training, individuals can increase their load-bearing capacity. This means that lifting a box won’t cause a disc herniation, falling on the soccer field won’t tear ligaments, cleaning windows won’t strain the arms, and office work won’t cause chronic muscle knots.
The COVID-19 pandemic clearly demonstrated the consequences of a sedentary lifestyle. Staying at home and becoming more inactive was detrimental to overall health. To maintain a healthy aging process, physical activity is essential.
After the age of 30, the rate of tissue breakdown increases. The only way to counteract this is through exercise. Unfortunately, due to excessive screen time on televisions, tablets, and phones, we are now seeing musculoskeletal problems—such as meniscus injuries, herniated discs, and chronic back and neck pain—emerge in younger individuals, even in their teenage years.
Our priority should be to ensure a healthy aging process through proper movement and physical conditioning. The time, money, and effort we do not invest in our health today will inevitably cost us more in the future.
Fzt. Canan Özkan
Physiotherapist
