Your hips were feeling stiff so your physical therapist performed massage on your glutes and you found you could squat deeper. Your physical therapist gave you a thoracic manipulation when you were experiencing neck pain and you suddenly found you could turn your head further to each side or lift your arms above your head without pain. The effects of manual therapy (massage, trigger point, manipulation, Graston or joint mobilization) are real but until recently have been somewhat misunderstood.
So why does manual therapy work? Before getting into a long winded explanation, the short answer is:
A complex phenomenon that is based on several factors such as patient education, your prior experiences and your nervous system.
As detailed in an editorial in the Journal of Orthopedic and Sports Physical Therapy, “manual therapy effects are multifaceted unlike drugs with identifiable ingredients and systemic interactions.” A stimulus such as touch, pressure or a metal tool has an effect on tissue stiffness and range of motion based on the way your physical therapist explains treatment to you and your beliefs about pain, which causes changes to your pain pathways, which release certain chemicals and decrease your pain. This allows you to move better with less pain among other feel good things that come along with physical therapy. This explains why after treatment your range of motion and mobility continue to improve while your pain continues to decrease. Manual therapy is not necessarily “breaking up scar tissue” or permanently increasing the length of your hamstrings. Because of the factors stated above, your body is able to “realize” you have underutilized available pain free mobility. It then becomes your responsibility as a patient / client (with the guidance of your physical therapist) to strengthen and maintain within your newly acquired range of motion.
If you are having pain, want to prevent pain, or want to improve your mobility to perform sports and your hobbies come in for a mobility assessment and treatment by contacting us at 212-439-1596 to set up an appointment.
– Dave Garaffa PT, DPT, CSCS