Within the physical therapy profession, manual therapy is defined as a clinical approach utilizing skilled, specific hands-on techniques, including but not limited to manipulation/mobilization, used by the physical therapist to diagnose and treat soft tissues and joint structures for the purpose of modulating pain; increasing range of motion (ROM); reducing or eliminating soft tissue inflammation; inducing relaxation; improving contractile and non-contractile tissue repair, extensibility, and/or stability; facilitating movement; and improving function.
Joint mobilization is a type of passive movement of a skeletal joint. It is usually aimed at a ‘target’ synovial joint with the aim of achieving a therapeutic effect. When applied to the spine, it is known as spinal mobilization. The different grades of mobilization are believed to produce selective activation of different mechanoreceptors in the joint.
Manual Energy Technique
Muscle Energy Technique is a type of osteopathic manipulative treatment used in osteopathic medicine and physical therapy. It is a form of osteopathic manipulative diagnosis and treatment in which the patient’s muscles are actively used on request, from a precisely controlled position, in a specific direction, and against a distinctly executed physician counterforce. It was first described in 1948 by Fred Mitchell, Sr, DO. Muscle energy techniques are used to treat somatic dysfunction, especially decreased range of motion, muscular hyper tonicity and pain.
These techniques are most appropriate for the following injury patterns:
Decreased range of motion secondary to muscular spasticity, rigidity, hypertonicity or hypo tonicity. Hyper tonicity often follows overuse and can result in altered joint position, increased irritability and decreased elasticity. This injury pattern is often accompanied by a non-specific muscle ache in the area of injury. Interneuronal injury– when dysfunction occurs at one joint or segment, the related agonist muscles are also affected. If uncorrected, the antagonistic muscles eventually become involved as well, leading to dysfunction of both muscle groups. This presents as decreased range of motion with pain and/or tenderness in the area.
The myofascial release approach is a form of soft tissue therapy used to treat somatic dysfunction and resulting pain and restriction of motion. It is a treatment described by Andrew Taylor Still, founder of osteopathy/osteopathic medicine, and his early students, which uses continual palpatory feedback to achieve release of myofascial tissues. It is accomplished by relaxing contracted muscles, increasing circulation and lymphatic drainage, and stimulating the stretch reflex of muscles and overlying fascia.
Fascia is the soft tissue component of the connective tissue that provides support and protection for most structures within the human body, including muscle. This soft tissue can become restricted due to psychogenic disease, overuse, trauma, infectious agents, or inactivity, often resulting in pain, muscle tension, and corresponding diminished blood flow. Although fascia and its corresponding muscle are the main targets of myofascial release, other tissue may be affected as well, including other connective tissue.