What Is Manual Medicine?
The origins of manual medicine begin in the worlds of physical therapy and osteopathy. Both realms have long recognized many musculoskeletal complaints and other clinical syndromes can extend from anatomic dysfunction. Headaches and hypertension are two examples where improper muscle tone can lead to symptoms, poor posture and breathing habits and ultimately into diagnoses allopathic medicine treats with “a pill.” Allopathic medicine may suggest exercise or stress reduction, but in almost every case, these two conditions are primarily addressed with an oral agent.
Manual medicine focuses diagnosis on regions that are working in a less optimal way and tries to correct that dysfunction. One treatment with manual medicine does not “cure” anything, but for many acute and chronic ailments, it can provide a path to decreased and ultimately no symptoms.
For the sake of this book, manual medicine is defined as any hands-on method that helps treat acute and chronic musculoskeletal pain.
Approaches and Philosophies
This approach is based on the theory that the body’s fasciae are interconnected. When the fascia of a particular area is dysfunctional, trigger points arise. Myofascial release is a massage technique that focuses on location and mobilization of these trigger points, which results in improved muscle function and decreased patient symptoms.
Positional Release Therapy
Dysfunction can lead to the formation of tender points (in muscles, ligaments, tendons, and joints). Treatment requires the clinician to:
Identify the tender point through palpation,
Maintain pressure on the tender point while you passively move the patient’s body toward the position of greatest comfort (resolving the tender point);
Hold the patient in this position for an extended period (often a minimum of 90 seconds);
Passively return the body part to neutral, resulting in the dissolution of the tender point.
Muscle Energy Techniques
Muscles that are shortened and in spasm can be lengthened by treating these muscles or by treating their antagonists. The treatment involves moving the region to its limit (called a restrictive barrier), then having the patient isometrically contract against a resistance, then relax. In that relaxation, move the region to a new limit and repeat. It has two approaches, post isometric relaxation (PIR) and reciprocal inhibition (RI).