What if I told you that the neurophysiological effects of manual therapy are only 15-20 minutes. Meaning, 20 minutes at the max, no more. Surprising?
What if I then told you that the same effects from our modalities (ultrasound, heat, laser, etc), aka the ones we use for comfort but know there is no evidence of effectiveness, yield the SAME length of relief?
If you are a manual therapist, does this resonate poorly with you? Does it make you mad? Or, just like that card game, you’re probably calling bulls#%!
Believe it or not, its true. The question remains, then how does manual therapy yield better results than just modalities?
We do know the interaction can be just as important as the technique. We also know that expectation, placebo and pre-existing beliefs have a huge role in benefits of musculoskeletal symptoms and resolution of pain.
But, don’t throw in the white flag on manual therapy and also don’t hang your hat on modalities.
I teach my interns that:
A mechanical stimulus is needed to start a chain of neurophysiological effects
The mechanical stimulus from manual therapy may be STRONGER than modalities. It can have the same duration of relief, but a more pronounced load on the body. In short, it can be the reset button needed, or buttons, needed to link the chains for recovery.