Manual therapy has been challenged over the past few years but is it the clinical outcomes or the suggested mechanisms that have been challenged? I don’t think we are really adjusting, breaking and releasing in the manner we were taught but patients continue to be satisfied by manual therapy seemingly unaware of the back room debates. In a recent research update by Pieters et al (2020) reporting on the effectiveness of Physical therapy for subacromial shoulder pain it was recognised that many factors have been identified as potential causes of this pain syndrome including; Kinematics involving capsular tightening, muscle dysfunctions, sustained work postures and overuse. The update champions exercise rehabilitation, further building upon its efficacy from previous reviews.
A strong recommendation was made in favor of exercises combined with manual therapy. Considered better than just exercise alone. The authors were unable to identify the specific types of manual therapy, instead just listing them, but this is evidence enough to get our hands back to work.
Have a read of the full study because it also mentions what doesn’t do a damn thing like therapeutic US.
Reference: Pieters, L., Lewis, J., Kuppens, K., Jochems, J., Bruijstens, T., Joossens, L., & Struyf, F. (2020). An Update of Systematic Reviews Examining the Effectiveness of Conservative Physical Therapy Interventions for Subacromial Shoulder Pain. The Journal of orthopaedic and sports physical therapy, 50(3), 131–141. https://doi.org/10.2519/jospt.2020.8498