Hi everyone,
I’m a second year DPT student from Michigan and I’ve been really wrestling with the whole concept of manual therapy in clinical practice. It seems to be very accepted and encouraged as a good therapeutic intervention by my professors and colleagues, despite the overwhelming evidence that seems to be out there that manual therapy may only offer short-term benefits at best, not to mention that these benefits may be due to placebo effect, patient/therapist beliefs/attitudes, etc.
One of the arguments that I often hear to support manual therapy by my colleagues and professors is that the short-term benefits of manual therapy can be utilized to the access new ROM and then load the tissues/body in this new ROM.
I’ve considered this and it seems reasonable, however listening to other up-to-date PT’s and BBM I’ve also heard the argument that the use of manual therapy could lead to a reliance pattern for the patient and therefore lack of patient self-efficacy.
Wondering if anyone could shed some more light on this argument for me and maybe some reasons why manual therapy should either: A) Not be used due to the reliance pattern created or B) Appropriate in some cases depending on the patient
Also as a side question: If a PT were to not use manual therapy, soft-tissue mobilization, and similar modalities, how one would properly educate a patient and in a way steer their beliefs about these passive modalities in the right direction, especially if they had strong beliefs about it?
Thanks!
John