How Manual Therapy actually works: revealing the TRUTH everybody should know.
- Elisabetta Brigo
- Nov 18, 2019
- 2 min read
“Manual Therapy” is an umbrella term for massage, joint manipulation, myofascial release, trigger point therapy,….You may think of it as ‘Hands On’ treatment.

Lots of people (health pros and clients alike) believe that Manual Therapy is the “Holy Grail”, the solution that will fix all of their ailments.
….except it’s NOT magic.

Let’s take a look at how Manual Therapy ACTUALLY works!
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Manual Therapy:
❌does NOT cause any STRUCTURAL changes
❌does NOT put VERTEBRAE “back in”
❌does NOT “realign” the SPINE
❌does NOT “break up” ADHESIONS
❌does NOT “rearrange” SCAR tissue
❌does NOT “lengthen” FASCIA
❌does NOT “release” MUSCLES KNOTS
❌does NOT “remove” WASTE products
❌does NOT have a PRECISE application
❌does NOT cause LASTING effects
❌does NOT “speed up” HEALING
❌does NOT magically “FIX” you
Ok, then.
But WHY we may feel less pain and “restricted” after the application of some Manual Therapy????

The deep scientific explanation is quite complex, but in simple words, what Manual Therapy actually does is sending a stimulus to our Nervous System, which consequently MAY influence the way our Brain makes us perceive pain and our body.

I said “MAY” because this effect depends a lot on each individual’s expectations and psychosocial factors.
So basically Manual Therapy MAY have a TRANSIENT (=lasts a FEW MINUTES only) effect on the Nervous System, but NOT mechanical/structural ones.
This means that Manual Therapy is NOT necessary nor sufficient to help you get better for good.

Manual Therapy will NOT resolve your back pain, nor heal your tendinopathy, nor cure your hamstring strain, nor “fix” your body.
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✅ All the most recent scientific evidence suggests that rehabilitation should be based on Exercise and Education, NOT Manual Therapy.

So if healthcare professionals decide NOT to use lower-value interventions such as Manual Therapy (at all or anymore), and rather focus on effectively educating their clients, encouraging physical activity and helping them manage stressor that are impairing their health,I think it’s more than fair and I totally support them.
And if they choose to keep practicing Manual Therapy I respect their choice, as long as they do it ETHICALLY,
–a.k.a. without fooling patients,
– a.k.a. without falsely advertise its benefits
– a.k.a. using the correct narrative around it,
– a.k.a. explaining what MT actually does and does NOT do.
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I know that some (senior) physiotherapists/chiropractors/osteopaths and similar will probably attempt to negate this or brutally attack me for exposing the truth about Manual Therapy, especially when their opinions and financial interests are challenged (I mean, selling 10 manual therapy sessions at $100 each to a client brings a lot of money in).
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But I believe people, especially those outside the profession, deserve to know the truth.
And I truly, truly hope this blog post shed some light on this controversial topic.
My goal is to EDUCATE you, so that you can make better choices, from an EMPOWERED position when it comes to your Health and Wellbeing 💙

Feel free to LIKE, SHARE and (not-too-brutally😅) COMMENT!
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Thanks for Reading!
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-Elisabetta Brigo
Physiotherapist

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Articles to Learn more:
Ho CY, 2009
Shin, 2012
Chaudry & Schleip, 2008,
Thalhamer, 2018;
Vardiman, 2015;
Nazari, 2019
Wiltshire, 2010;
Rubinstein, 2019
Fredin, 2017;
Bizzarri, 2018
Bialosky, 2009;
Bishop, 2015;
Vigotsky, 2017;
Bialosky, 2018
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