What’s the Difference?
Manual and physical therapy are terms that can cause confusion. Many people use the terms interchangeably. Physical therapists in the United States, however, do not. So what’s the difference between physical therapy and manual therapy? We’re glad you asked!
Remember learning about sets and subsets in math? The bottom line is this: manual therapy is a subset of physical therapy. So while all manual therapy qualifies as physical therapy, not all forms of physical therapy are included in what we call manual therapy.
Notice, too, that we said “in the United States.” In other parts of the world, the terminology they use for manual and physical therapy sometimes differs from ours. You are more likely to see the term physiotherapy, for example. Not to worry! We’ll tell you what we mean when we refer to manual and physical therapy!
Why does it matter?
As long as you receive the appropriate therapy what difference does it make that you understand the difference between manual and physical therapy? At Midland Physical Therapy, we think you should fully understand the treatment you are receiving and why one treatment is recommended rather than another.
We’re flattered when our clients trust our judgment regarding their manual and physical therapy, but we take educating our clients seriously. When patients know why as well as how they are being treated, the outcome improves because knowledgeable patients tend to be more motivated and compliant patients.
Manual or Physical Therapy?
The word manual has a number of meanings, including the word physical. Is it any wonder people feel confused? When it comes to manual therapy, the relevant meaning for us is “using the hands” or “hands-on.” For physical therapists, manual therapy is literally hands-on therapy. A physical therapist uses his or her hands to provide treatment.
Physical therapy includes additional treatments that you could call “hands-off.” One visit to our facility will show you why. Physical therapists often assist patients in using exercise equipment to restore their bodies.
Among physical therapists, the difference between manual and physical therapy has nothing to do with one form being better than the other. It’s only in specific instances or cases that one form of therapy might provide a more appropriate and effective treatment.
One significant distinction between manual and physical therapy has to do with being able to identify the source of a patient’s problem. Physical therapists who are trained in the techniques of manual therapy can use their hands to isolate the specific tissue or joint that is causing the patient’s symptoms. The hands provide information that no other assessment tool can replicate.
Which is it?
Let’s run through some examples of manual and physical therapy treatments. You’ll begin to see the advantage of each form as well as the advantage of combining these treatments strategically.
Let’s say you are experiencing pain in your knee. It’s important to determine the reason for your pain before treatment begins:
- Is your pain a result of osteoarthritis?
- Is your pain related to an injury that has damaged the cartilage or torn a ligament?
- Or are you recovering from knee replacement surgery?
Your specific situation might dictate different exercises or treatments, but we can offer some general information to illustrate how manual and physical therapy can work together to treat knee pain. Here’s a hypothetical case:
Manual Therapy: Assessing Your Condition
First, your physical therapist might begin with hands-on therapy to assess the extent of swelling and inflammation surrounding the knee joint. Manual therapy techniques help your physical therapist gauge the condition of your muscles and tissues. You can tell your therapist where it hurts, but manual therapy will also tell your therapist where it hurts.
When you experience pain, you have probably noticed that you have an instinct to protect your body where you are injured. Sometimes we say that we’re “favoring” an injury; in our hypothetical case, you’re favoring your knee. Therapists or doctors refer to this instinct as “muscle guarding.”
If you’ve been injured before, you might be aware that the more you favor an injury, the more likely you’ll end up with up with stiffness. Here’s why:
- Favoring a muscle means that it’s in a constant state of contraction.
- Constant contraction of a muscle leads to poor circulation.
- Poor circulation leads to muscle or tissue being deprived of nutrients and oxygen.
- Deprivation leads to hardening and stiffness.
In the case of a joint injury, here’s what else happens:
- Your injury leads to local swelling around the joint.
- Your muscles related to the joint guard against the pain.
- When the inflammation goes away, the joint is stiff because of scar tissue.
Favoring your knee by keeping it immobile doesn’t allow your circulation to provide sufficient oxygen and nutrients to heal the injury properly. If you move your joints with proper assistance from your physical therapist or exercise equipment, you can reduce the build-up of scar tissue.
Manual Therapy: Dealing with Inflammation
Because your instinct is to favor your knee, manual therapy can be a good starting point for your recovery. Your physical therapist has a variety of soft tissue mobilization and myofascial release techniques that can help you. Specific joint mobilization or manipulation techniques allow your joint surfaces to move better.
After performing a manual therapy technique, your physical therapy exercises will be easier to perform. The concept is similar to warming up the body before engaging in more strenuous exercise. Manual therapy can “loosen up” your joint so you can perform exercises with less pain.
These exercises, with or without the use of equipment, are essential for your recovery. Manual therapy is great for alleviating swelling and improving circulation. However, inactivity leads to muscle atrophy or weakness. You need physical therapy to rebuild muscle.
Physical Therapy: Stretch & Strengthen
When you think of traditional physical therapy, you’re likely thinking about the exercises your therapist asks you to do. They might be exercises you can perform at home or they might be exercises you perform on equipment at the rehabilitation center. Either way, your physical therapy will involve both stretching and strengthening exercises.
To take care of your aching knees, you need to strengthen your quads and hamstrings. When you strengthen these muscles in your thigh, you help the knee absorb shock. Depending on your current condition, you might use equipment or you might be ready for leg lifts and knee bends.
It’s important to include stretching exercises along with strengthening exercises. When you strengthen your muscles, the muscles tend to tighten. Tight muscles are more prone to injury. To avoid re-injury, gently stretching your muscles will help keep them flexible.
Both/And Rather Than Either/Or
We hope the difference between manual and physical therapy is clearer for you now. Manual and physical therapy both contribute to your overall recovery. Your treatment plan will likely incorporate both types of therapy over the course of your rehabilitation. You need both manual and physical therapy to heal properly.
Manual and Physical Therapy Team
Manual and physical therapy make a great team. Each therapy has its advantages, and together they’re a dynamic duo! At Midland Physical Therapy, we have therapists who are trained in both manual and physical therapy techniques. That means that you and your therapist make a dynamic duo, too!
For access to the full range of techniques you need to recover from injury or other health conditions, contact us today to schedule an appointment with Midland Physical Therapy. Whether you need manual or physical therapy, you can rest easy knowing that you are receiving the best treatment for your symptoms.