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Manual Therapy- what does it do and why is it used?

Written by Jennifer Rouse, DVM CCRP Aug 18 • 4 minute read

What is Manual Therapy?

Simply put, manual therapy is therapy performed by the therapists hands. It usually encompasses things like massage, joint mobilizations, traction, and stretching to improve flexibility, range of motion of a joint, reduce pain, and otherwise enhance and improve mobility for a patient. 

Isn’t rehab really about using gadgets like laser and underwater treadmill? 

Not at all! The most important tools a therapist has is our hands. By feeling a patient, we can identify issues that can restrict motion and otherwise cause pain. Detecting those issues can avoid encouraging abnormal or compensatory body mechanics that can at best cause an animal to have reduced efficacy from exercise modalities and at worst set up for other injuries if a patient is using their body in a wrong way. Some conditions like iliopsoas strain are actually not recommended for underwater treadmill due to the nature and location of that injury and how a patient would use their body in the water. 

What are the types of Manual Therapy? 

Massage: Various types of massage are used to help increase blood flow and warm up areas of concern. By increasing blood flow to an area, we can help to bring important nutrients and healing factors to that area. Blood flow is also responsible for carrying away waste products of muscle metabolism like lactic acid. When a muscle is tense and it persist over time, blood flow can be reduced or restricted which further exacerbates any pain or damage in the area. A focused area of tension in a muscle is known as a trigger point. This is an area where muscle tissue is so constricted that little blood flow reaches the spot (technically called ischemia.) A specialized type of massage known as myofascial release is used to relax a trigger point and restore blood flow. Fascia is the fine mesh like scaffolding that helps to hold everything in place! Muscles, skin, nerves, vessels and other structures. Fascia is a newer area of research in that we still don’t know everything that it does! What we do know is that when surgery or an injury occurs, fascial restrictions can occur (like scar tissue) that can cause the normal structure to be altered and that can result in pain and decreased movements. Myofascial release deals with restoring the normal mechanics of these restricted areas and ultimately reducing pain in those areas. 

Joint Mobilizations: The skilled use of controlled pressure or force on a joint at a specific area of range of motion to loosen deeper structures like ligaments and joint capsules. It is similar but not quite the same as a manipulation that a chiropractor uses. The type of joint and area of restriction often dictates the type and direction of motion used for a specific joint mobilization. These motions can not only improve range of motion of the joint, but also help reduce pain in the area. 

Traction: Traction is the pulling on a joint and is most often associated with spinal treatments but any joint can be tractioned. In the spine, creating space in the joint by traction can reduce pressure on surrounding nerves and discs. In all joints, traction can help to stretch soft tisssue structures surrounding the joint and lessen or eliminate muscle spasms. 

Passive Range of Motion: This technique helps to improve distribution of joint fluid and overall improve the health of the joint. It can allow for the assessment of the true range of the joint without having to rely on the surrounding muscles to perform the movement. Active range of motion is what the patient can achieve in range of motion using their muscles to drive movement. A restriction in active extension of the hip that does not have passive range of motion restrictions would suggest a neuro or muscle problem rather than a joint specific issue. 

Stretching: Stretching is divided into active and passive stretching. Active stretching is often employed by coaxing a patient to move fully through their range of motion to warm up for an exercise or exertion. These include things like “cookie stretches” where a patient follows a treat and bends or otherwise stretches in the process of reaching for a treat, and “circling,” “weave,” or “figure of 8’s” that help to warm up core muscle groups. Passive stretching is always performed AFTER a patient is finished with any vigorous activity and helps to improve and maintain range of motion of a joint. It is generally performed by the therapist or owner on the patient and is a passive process. (For example: Patient lies still and therapist moves the limb to full extension and holds for a stretch.) 

As with any treatment, Manual Therapy has it’s place in the therapists tool box. Some technique are indicated for certain conditions but shouldn’t be used under other circumstances. Curious about whether Manual Therapy could benefit your pet’s condition? Please contact us at the widget in the lower right hand corner of this website and we can help decide if a consult is right for your pet!

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