Manual Therapy, or Manipulative Therapy, is a physical treatment primarily used by Physical Therapists, massage therapists, physiotherapists, occupational therapists, chiropractors, osteopaths, and osteopathic physicians to treat musculoskeletal pain and disability; it most commonly includes kneading and manipulation of muscles, joint mobilization and joint manipulation. Korr (1978) described manual therapy as the "Application of an accurately determined and specifically directed manual force to the body, in order to improve mobility in areas that are restricted; in joints, in connective tissues or in skeletal muscles." Three notable forms of manual therapy are manipulation, mobilization and massage. Manipulation is the artful introduction of a rapid rotational, shear or distraction force into an articulation.
Manipulation is often associated with an audible popping sound caused by the instantaneous breakdown of gas bubbles that form during joint cavitation. Other Styles of Manual Therapy:
Massage Therapy or Medical Massage
Medical massage is outcome-based massage, primarily the application of a specific treatment targeted to the specific problem(s) the patient presents with a diagnosis and are administered after a thorough assessment/evaluation by the medical massage therapist with specific outcomes being the basis for treatment. It is also known as clinical massage or treatment massage.
There are many massage schools and programs that teach medical massage as a technique. Though medical massage is any massage treatment used to treat specific medical conditions. There is no one technique that is medical massage (literary review). Medical massage is taking whatever style of massage the practitioner knows and applying that technique to specific conditions to bring about specific outcomes.
Massage has been used as a medical treatment dating back to the Chinese over 5000 years ago. More recently Professor Silas Weir Mitchell (1829-1914), a neurologist in Philadelphia is thought to be the first to bring massage to the attention of the US medical community. In 1884, Douglas Graham, MD of Boston Massachusetts wrote A Practical Treatise on Massage which focuses on the treatment of specific diseases and disorders by using massage as a treatment. In 1885, Dr Harvey Kellogg published the classic textbook The Art of Massage, Its Physiological Effects and Therapeutic Actions. During the nineteenth century, massage in Europe was described in the medical literature and was taught at institutions and also offered by lay practitioners. In 1886, William Murrell, an English Physician wrote a book Massage as a Mode of Treatment. In Russia, M.Y. Mudrov, MD used massage and movement exercises in his medical practice with adults and later applied it to the development of children.
The American Medical Massage Association (1998) and The United States Medical Massage Association (1999) followed with similar goals of lifting the profession to higher standards and, in turn, giving patients a better outcome. The AMMA has worked with the standard medical community to bring massage therapy into the mainstream; they have done this through a board of advisers that includes massage therapists, physicians, chiropractors etc.
Other Forms & Specialized
Types of Massage Therapy
Active Release Technique
Active release technique (ART) is a form of deep tissue manipulation patented by P. Michael Leahy in which specified techniques are used to release what are presumed to be soft tissue adhesion's.
Acupressure Acupressure [from Latin acus "needle" (see acuity) + pressure (n.) is an alternative medicine technique similar in principle to acupuncture. It is based on the concept of life energy which flows through "meridians" in the body. In treatment, physical pressure is applied to acupuncture points with the aim of clearing blockages in these meridians. Pressure may be applied by hand, by elbow, or with various devices.
Some medical studies have suggested that acupressure may be effective at helping manage nausea and vomiting, for helping lower back pain, tension headaches, stomach ache, among other things, although such studies have been found to have a high likelihood of bias.
Aquatic therapy Aquatic bodywork comprises a diverse set of massage and bodywork forms performed in water. This includes land-based forms performed in water (e.g., Aquatic Craniosacral Therapy, Aquatic Myofascial Release Therapy, etc.), as well as forms specific to warm water pools (e.g., Aquatic Integration, Dolphin Dance, Healing Dance, Jahara technique, WaterDance, Watsu).
In ashiatsu, the practitioner uses their feet to deliver treatment. The name comes from the Japanese, ashi for foot and atsu for pressure. This technique typically uses the heel, sesamoid, arch and/or whole plantar surface of foot, and offers large compression, tension and shear forces with less pressure than an elbow, and is ideal for large muscles, such as in thigh, or for long-duration upper trapezius compressions. Other manual therapy techniques using the feet to provide treatment include Keralite, Barefoot Lomi Lomi, Chavutti Thirumal.
Ayurvedic Massage known as Abhyangam in Sanskrit is one of the most common and important Ayurvedic therapies. According to the Ayurvedic Classics Abhayngam is an important dincharya (Daily Regimen) that is needed for maintaining a healthy lifestyle. The massage technique used during Ayurvedic Massage is known to stimulate the lymphatic system to expel the toxins out from the body. The Ayurvedic Massage also stimulates production of lymphocytes which play a vital role in maintaining the immunity in human body. Thus regular Ayurvedic Massage can lead to better immunity and also help in body de-toxification. The other benefits of regular Ayurvedic Massage include pain relief, reduction of fatigue, prevention of ageing and bestowing longevity.
Biodynamic massage Biodynamic massage was created by Gerda Boyesen as part of Biodynamic Psychotherapy. Practised as a stand-alone therapy, it is a combination of physical and energy work and also uses a stethoscope to hear the peristalsis.
Craniosacral therapy Craniosacral therapy (CST) is a gentle approach that releases tensions deep in the body by applying light touch to the skull, face, spine, and pelvis.
While various types of reflexology related massage styles focus on the feet, massage of (usually) the soles of the feet is often performed purely for relaxation or recreation. It is believed there are some specific points on our feet that correspond to different organs in the body. Stimulation of these points during foot massage can cause significant reduction in pain. Studies also suggest that foot reflexology massage can reduce fatigue and promote better sleep.
Lomilomi & Indigenous
Massage of Oceania
Lomilomi massage Lomilomi is the traditional massage of Hawaii. As an indigenous practice, it varies by island and by family. The word lomilomi also is used for massage in Samoa and East Futuna. In Samoa, it is also known as lolomi and milimili. In East Futuna, it is also called milimili, fakasolosolo, amoamo, lusilusi, kinikini, fai’ua. The Māori call it roromi and mirimiri. In Tonga massage is fotofota, tolotolo, and amoamo. In Tahiti it is rumirumi. On Nanumea in Tuvalu, massage is known as popo, pressure application is kukumi, and heat application is tutu. Massage has also been documented in Tikopia in the Solomon Islands, in Rarotonga and in Pukapuka in Western Samoa.
Manual lymphatic drainage Manual lymphatic drainage is a technique used to gently work and stimulate the lymphatic system, to assist in reduction of localized swelling. The lymphatic system is a network of slow moving vessels in the body that carries cellular waste toward the heart, to be filtered and removed. Lymph also carries lymphocytes, and other immune system agents. Manual lymphatic drainage claims to improve waste removal and immune function.
Myofascial release Myofascial release refers to the manual massage technique that claims to release adhered fascia and muscles with the goal of eliminating pain, increasing range of motion and equilibrioception. Myofascial release usually involves applying shear compression or tension in various directions, cross fiber friction or by skin rolling.
Shiatsu Shiatsu (指圧) (shi meaning finger and atsu meaning pressure) is a type of alternative medicine consisting of the fingers and palm pressure, stretches, and other massage techniques. There is no convincing data available to suggest that shiatsu is an effective treatment for any medical condition.
Structural integration Structural Integration's aim is to unwind the strain patterns residing in the body's myofascial system, restoring it to its natural balance, alignment, length, and ease. This is accomplished by deep, slow, fascial and myofascial manipulation, coupled with movement re-education. Various brands of Structural Integration are Rolfing, Hellerwork, Guild for Structural Integration, Aston Patterning, Soma, and Kinesis Myofascial Integration.
The most widely recognized and commonly used category of massage is the Swedish massage. The Swedish massage techniques vary from light to vigorous. Swedish massage uses five styles of strokes. The five basic strokes are effleurage (sliding or gliding), petrissage (kneading), tapotement (rhythmic tapping), friction (cross fiber or with the fibers) and vibration/shaking. Swedish massage has shown to be helpful in reducing pain, joint stiffness, and improving function in patients with osteoarthritis of the knee over a period of eight weeks. The development of Swedish massage is often inaccurately credited to Per Henrik Ling, though the Dutch practitioner Johann Georg Mezger applied the French terms to name the basic strokes. The term "Swedish" massage is actually only recognized in English and Dutch speaking countries, and in Hungary. Elsewhere the style is referred to as "classic massage".
Clinical studies report that Swedish Massage can effectively reduce low back pain and the effectiveness can last for as long as 15 weeks. One study reported that Swedish Massage caused reduction in salivary cortisol indicating its role in management of stress and improvement in mood.
Thai massage Known in Thailand as นวดแผนโบราณ (Nuat phaen boran, IPA: [nûət pʰɛ́ːn boːraːn]), meaning "ancient/traditional massage", Traditional Thai massage (Nuad Boran) is generally based on a combination of Indian and Chinese traditions of medicine.
Thai massage – or Nuat Thai – combines both physical and energetic aspects. It is a deep, full-body massage progressing from the feet up, and focusing on sen or energy lines throughout the body, with the aim of clearing blockages in these lines, and thus stimulating the flow of blood and lymph throughout the body. It draws on yoga, acupressure and reflexology.
Thai Massage is a popular massage therapy that is used for management of conditions such as musculoskeletal pain and fatigue. Thai Massage involves a number of stretching movements that improve body flexibility, joint movement and also improve blood circulation throughout the body. In one study scientists found that Thai Massage showed comparable efficacy as the painkiller ibuprofen in reduction of joint pain caused by osteoarthritis (OA) of the knee.
Traditional Chinese Massage
Traditional Chinese medicine Massage of Chinese Medicine is known as An Mo (按摩, pressing and rubbing) or Qigong Massage, and is the foundation of Japan's Anma. Categories include Pu Tong An Mo (general massage), Tui Na An Mo (pushing and grasping massage), Dian Xue An Mo (cavity pressing massage), and Qi An Mo (energy massage). Tui na (推拿) focuses on pushing, stretching, and kneading muscles, and Zhi Ya (指壓) focuses on pinching and pressing at acupressure points. Technique such as friction and vibration are used as well.
Trigger Point Therapy
Sometimes confused with pressure point massage, this involves deactivating trigger points that may cause local pain or refer pain and other sensations, such as headaches, in other parts of the body. Manual pressure, vibration, injection, or other treatment is applied to these points to relieve myofascial pain. Trigger points were first discovered and mapped by Janet G. Travell (President Kennedy's physician) and David Simons. Trigger points have been photomicrographed and measured electrically. and in 2007 a paper was presented showing images of Trigger Points using MRI. These points relate to dysfunction in the myoneural junction, also called neuromuscular junction (NMJ), in muscle, and therefore this technique is different from reflexology, acupressure and pressure point massage.
Tui na Tui na is a Chinese manual therapy technique that includes many different types of strokes, aimed to improve the flow of chi through the meridians.
Watsu Watsu, developed by Harold Dull at Harbin Hot Springs, California, is a type of aquatic bodywork performed in near-body-temperature water, and characterized by continuous support by the practitioner and gentle movement, including rocking, stretching of limbs, and massage. The technique combines hydrotherapy floating and immersion with shiatsu and other massage techniques. Watsu is used as a form of aquatic therapy for deep relaxation and other therapeutic intent. Related forms include WaterDance, Healing Dance, and Jahara technique.
Page was last checked and updated on June 10th, 2018