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  • Dori Nissenson

Hands On At Home

My goal as a physical therapist is to help people feel better, move better and ultimately live better.

In order to make this happen for my patients, I use a hands-on approach where my focus is treating pain and dysfunction with manual soft tissue and joint mobilization. This allows me to enhance and maintain physical performance, to increase the ability for my patients to function normally, and to prevent or remediate painful syndromes in the body that keep us from feeling good doing what we love to do.

I believe that physical therapy will only work with a hands-on approach...which is why I am truly...

What Is Manual Therapy???

Manual therapy refers to the assessment and treatment of pain and dysfunction through the use of skilled hand movements and skilled passive movements of the joints, soft tissue, fascia, and nerves.

Manual techniques are intended to decrease pain, swelling, inflammation, and restriction, and to improve tissue extensibility, range of motion, as well as induce relaxation…returning you to your maximum functional capacity.

How Does Manual Therapy Work???

Unfortunately, there is no one answer to this question. Furthermore, this is a question that the PT profession has been working toward answering for many years through the undertaking of extensive research.

In a nutshell:

The manual force applied by the PT stimulates a cascade of effects, beginning with the stimulation of the peripheral nervous system which then sends information to the brain.

The brain then sends the information received from the peripheral nervous system to the spinal cord which links your brain to your body. The spinal cord and the peripheral nervous system form a feedback loop. Using this loop, the peripheral nervous system causes the relaxation of the tissues in the area that are being manipulated.

Who Would Benefit From Manual Therapy?

The answer is ANYONE…... But that being said you may benefit from manual therapy if you:

  1. are in pain

  2. have an acute injury

  3. have an old injury that still bothers you often feel stiff

  4. feel that your physical performance during activities of daily life or work or sport are either causing you pain or are more difficult than they used to be for you

  5. are falling or losing your balance a lot

What Are The Different Types Of Manual Therapy?

Manual therapy includes the following: 1. Myofascial Therapy: This technique targets the muscle and fascia systems, and promotes flexibility and mobility of the body’s connective tissue. It is used to mobilize adhesions and reduce restriction throughout the body’s wide web of fascia.

2. Massage: This technique is primarily used to reduce swelling in extremity joints and muscles.

3. Friction Massage: This technique is used to increase the mobility of adhesions between fascial layers, muscles and other soft tissues by triggering an inflammatory response to draw healing to the area in focus.

4. Soft Tissue Technique: This is a firm direct pressure to relax muscles that have too much input from the brain and to stretch tight fascial structures. 5. Trigger Point Technique: This technique is used to address myofascial trigger points which are many overactive muscle spasms that often radiate pain from the point of origin.

What Role Does The Physical Therapist Play?

Most diagnoses of pain or dysfunction require manual therapy to improve. Therefore, it is imperative that you contact a licensed physical therapist who is highly skilled in manual therapy techniques in order to maximize pain-free function.

Your physical therapist will start you on a program of manual therapy that will include:

1. a full, thorough assessment of the affected area and surrounding areas using manual techniques

2. treatment of the affected and surrounding areas using some or all of the manual techniques listed above

3. education in correct postural alignment during work, sport, or daily activities to maintain the changes that your PT has made to your soft tissues and joints

4. education in appropriate exercises to maintain the soft tissue and joint mobility that results from the manual techniques

5. an ergonomic assessment of your car or workstation to prevent recurrence of joint and soft tissue restriction due to poor posture in these environments

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