What is Manual Therapy?

Manual therapy is a form of physical therapy applied only by hand without using any device or machine. In manual therapy, practitioners use only their hands to manipulate joints in the area and exert pressure on muscle tissue to reduce the pain caused by muscle spasm, muscle tension, and joint dysfunction.

Who Can Be Applied Manual Therapy?

Manual therapy can help in the treatment of people with joint disorders in some musculoskeletal structures with insufficient mobility and lack of range of motion. These disorders can cause pain and changes in function, posture and movement in the person. Manual physical therapy is used to strengthen the mobility of the joints and reduce muscle tension to enable the patient to move more naturally without suffering. Manual therapy can provide relief to individuals in the treatment of joint problems and ligament withdrawals such as sacroiliac joint dysfunction, chronic low back pain, acute back pain caused by soft tissue injuries, back muscle tension. It appears to be effective in the treatment of patients with chronic low back and back pain after manual therapy. Manual physical therapy techniques include a variety of applications:

●        Pressure is applied to soft tissues and muscles, including massage. This pressure relaxes the muscles, increases circulation, helps to break down damaged tissue and reduces pain in soft tissues.

●        The mobilization / manipulation method, which involves movements at different speeds (from slow to fast), is used to bend, pull or push the bone and joints (from light to strong) and stretch (called 'amplitude').

Myofascial relaxation is a manual therapy method applied holistically to the muscles and the surrounding fascia through mechanical stimulation. It is a comprehensive approach for the evaluation and treatment of the muscle and fascia system in the body.

This technique is designed to release restrictions such as trigger points, muscle tension and dysfunctions in soft tissue that may cause pain and limit movement in all parts of the body. It has been successful in reducing pain and increasing mobility. When mechanical stimulation is applied to the muscles and the surrounding fascia, fascia relaxation is provided, tension and irregular tensions are relaxed. The main tissue focus for myofascial relaxation is fascia. Myofascial relaxation allows the evaluation, identification and treatment of tensions and limitations within the fascia. These limitations can be caused by many factors such as trauma, musculoskeletal disorders, and posture disorders.

Physical therapy sessions and exercise programs, which occupy the most important place in treatment, have been used for many years because they reduce complaints and can be applied safely.

Hot application in physical therapy, currents for reducing pain such as tens or interference, ultrasound, laser, hil therapy, traction, cupping treatment, massage, taping, dry needling, trigger point injections, mobilization and manipulation applications can be performed.

The main model of kinesio taping applications is applications for inhibition (inhibition of function) or facilitation (facilitation of function) of muscles. It is a great advantage in use that the effect of kinesio taping starts as soon as it is applied and the effect continues as long as the tape remains on the person.  Especially in cases of acute pain, it is pleasing for both the physician and the patient that the patient's pain relieves while leaving the examination room.  Since it is non-invasive and does not have the characteristics of a medication, it appears as a treatment option that can be applied at the first stage in cases of acute pain.  In the time of period until the control examination, where the results of the examination is evaluated and the definitive diagnosis is made, the kinesio taping is a candidate to enter the treatment guidelines as a primary care option.  The tape can easily stay on the person for 3 to 5 days.  It is resistant to water provided that it is applied a few hours ago. One can easily take a bath.  However, the top of the tape should not be rubbed by hand or fiber.   For the guests receiving physiotherapy, the kinesio taping can be applied on the days when the therapy is not applied and at the weekends in terms of continuation of the treatment.

Orthopedic Physiotherapy is a branch of physical therapy applied in the treatment of orthopedic diseases and injuries, and in the recovery of postoperative movements and functions. The aim of the orthopedic physiotherapy program is to gain muscle and joint smoothness, to maximize the functional capacity and independence of the patient, and to provide normal activity level.

The Graston Technique is a form of manual treatment known as tool-assisted soft tissue mobilization. Graston massage is performed using titanium-plated metal rods specially designed for different parts of the body. The aim of the technique is to provide soft tissue mobilization by opening the scar (adherent) tissues and increasing circulation. Graston massage is especially preferred to increase the mobility of the fascia and to treat tears or injuries in the muscle, tendon and soft tissue. Graston technique is frequently preferred by chiropractors, physiotherapists and osteopaths.

The word recovery means healing, recuperation and restoration. It is an important rehabilitation modality for athletes to accelerate the recovery process of your muscles in your intense training pace, to prevent the dull pains you suffer from affecting your movement in your later training, to minimize your risk of injury, and to support performance increase and continuity.

The role of the physiotherapist in recovery is to identify manual techniques and exercises that will increase the oxygenation of the muscles and to assist the athlete correctly. At the same time, it is to apply stretching exercises and combined techniques to extend the length of the muscle that is prone to shortening due to density. The rest period shortened in peak periods should be compensated by personalized recovery programs. 

Posture is the most appropriate positioning of each part of the body in proportion to their adjacent segments and the whole body. The body achieves a smooth posture as a result of the harmonious functioning of many muscles to ensure stability with the support of ligaments or to form the basis of a movement during muscle activity.

Inactivity, working in a certain form of posture necessarily in business life can lead to significant posture problems. A miner's posture and a pianist's posture are, of course, different. However, the rules for healthy posture and walking are the same for everyone. Although there are many factors affecting adult posture, three of them have gained importance in terms of frequency. Familial and hereditary prominent dorsal kyphosis and excessive lordosis congenital or delayed structural disorders; paused or progressive anomalies in nerve, muscle and connective tissue; acquired poor postures due to habits during the developmental period or wrong training

Physiotherapists also work to solve this situation with regular work and support equipment with an appropriate exercise program. Exercise is organized specifically for the individual's situation. The right exercises and the right posture for a painless and healthy body should be integrated into one's life and turn into a way of life.

Physiotherapy is necessary for the treatment and prevention of the problem by taking professional approaches in back pain as in many types of pain. The most important difference that distinguishes back problems from other areas is the lack of exercises to be done for the back and the difficulty of intervention on the person's own back. Physiotherapists apply different techniques for patients to return to the level of activity before disability, firstly to relax the back, then to strengthen it and then to regain the ability to move.

Lymphedema is an inadequacy in lymph drainage and accumulates in protein-rich intercellular fluid, skin and subcutaneous tissues. As a result of this accumulation, swelling occurs in areas with lymph flow disorder.

Lymph fluid is drained with the physiotherapy technique. This technique is a manual treatment method. The lymphatic fluid in the area is drained by applying message therapy to the lymphatic area. Afterwards, compression is applied to the region to increase the muscle activity of the patient. Compression is the second stage of lymphedema treatment. Pressure is applied to the area in compression therapy. In this way, the healing of the region is accelerated.

The tailor-made physical activity program is followed by the physiotherapist according to the duration, intensity and type of exercise, the resume of the individual and the coexisting musculoskeletal and other system problems. A program consisting of posture, stretching, muscle strengthening, balance and coordination exercises and aerobic exercises such as bicycle ergometer, swimming and walking is organized according to the needs of the patient. Eligible patients can attend group or individual pilates or yoga classes.