Over the past year or so, I have increasingly been reading, hearing or engaging in conversations regarding manual therapy and its “place” within physical therapy. It is clear that manual therapy is popular with addressing musculoskeletal conditions and is supported in the medical literature. However, manual therapy has been taking on more criticism, which is not a bad thing. The issue I see is that manual therapy is seen a treatment that is only used in the traditional outpatient setting and is purely passive in nature. This is farthest from the truth.
If we boil manual therapy down to what it truly is, skillful touch, we can strip the idea that this treatment approach is setting specific. If all PTs were to reflect on their practice regardless of their setting, I would argue that almost all would say that they have utilized skillful touch in their practice. Doesn’t a transfer of a patient with moderate assistance require manual therapy? What about the patient learning to walk again who needs tactile facilitatory input to improve the swing phases of gait – isn’t this manual therapy? I could go on.
The fact is that any time we skillfully lay our hands on a patient we are performing manual therapy. This idea that there is a dichotomy of being hands on or hands off is essentially saying that we give up what makes us truly PTs.
Far too long have people looked at manual therapy as a purely passive treatment and it clearly is not. We touch people when they are moving. We touch people to facilitate moving. We touch people to enhance moving. This is manual therapy.
I encourage continued discussions on advancing manual therapy within our profession. We must acknowledge that this is something that most all PTs use in some form or fashion across practice settings. Finally, I challenge you to think of manual therapy as not being a passive intervention.