Manual Physiotherapy refers to a physiotherapist who is knowledgeable and skilled in one or more manipulative treatments. In Turkey, a specialist physician must be present while performing these techniques.
There are various practices and laws abroad.
The physiotherapy treatment program should be applied by a physiotherapy physician or physiotherapist who has received proper training. Do not seek services from individuals such as fracture and dislocation specialists, physiotherapy technicians, or nurses who have not received education in this field.
Electrical devices used in treatment are called electrotherapy, and it is a very small part of physiotherapy. It does not constitute the main treatment; it is just a part. Therefore, treatments that only involve heat agents and electrical devices do not provide significant results. As understood by the name, physical therapy should be a treatment method based on physical interventions applied to the body.
Manual therapy means hands-on treatment. It involves techniques such as mobilization/manipulation (joints), soft tissue techniques, etc., applied to the body to treat restrictions, pain, and loss of function in joints, spine, connective tissues, and muscles.
Mobilization: A method used to increase mobility and reduce pain by applying controlled, oscillating, or fixed forces to physiological or accessory movements in joints. The patient can stop the movement. Example: Mulligan Concept.
Manipulation: Can be performed under anesthesia and involves applying high-velocity, short-amplitude movements to a joint without surpassing its anatomical range of motion. The patient cannot block the movement. A "click" sound is often heard.
Soft tissue techniques: These are various massage techniques applied to soft tissue, such as Deep Stroking Massage, Friction Massage, Scar Tissue Mobilization, etc.
"Manus" means hand, and "therapy" means treatment. Manual therapy refers to specific maneuvers and techniques that are hands-on and used to find and eliminate the causes of existing problems without the use of medications.
Manual therapy is frequently used in spine disorders but can also be applied to other joints in appropriate indications.
Manual therapy is an indispensable treatment method for restoring movement in conditions caused by joint stiffness, joint freezes (contractures, etc.), as well as movement deficiencies and hypomobility due to muscle shortening and spasms.
Many academies and institutes have been established worldwide, especially in the field of manual therapy. However, in our country, manual therapy and electrotherapy (hot packs, ultrasound, TENS, and sometimes interferential current, device-based traction, etc.) are still applied in physical therapy.
From the time of Hippocrates to the present, these therapeutic methods have evolved and are recognized as scientific treatments by the World Health Organization. In developed countries, manual physiotherapy has been applied for more than a century in the treatment of pain and functional disorders in the human body. In Turkey, however, it is still performed by very few specialists.
The difference between manual therapy and classical physical therapy is that it focuses on recovery and tissue repair, rather than just symptoms, and aims for irreversible, excellent, or very good outcomes.
Manual therapy is applied in lumbar and cervical disc herniations, mechanical back pain, and facet syndrome, with successful results.
Aside from spinal issues, manual therapy is also very effective in treating soft tissue injuries, orthopedic problems, pre- and post-surgical rehabilitation, sports injuries, rheumatic diseases, osteoarthritis, and joint pain. In some cases of disc displacement requiring surgical intervention, manual therapy can promote healing, depending on the severity of the condition.
In manual therapy, nerve impingements caused by muscles and/or joints can be relieved, and as a result, conditions like migraines, headaches, asthma, indigestion, arthritis, and even some emotional disorders can be treated.
For manual therapy to be effective and safe, a detailed assessment of the patient's locomotor system is required, considering its anatomical, biomechanical, and neurophysiological aspects.
Therefore, manual therapy should be performed by specially trained physiotherapists or physicians who can determine the appropriate techniques, indications, and contraindications. Otherwise, serious complications may arise.
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