A Clinically-Reasoned Approach to Manual Therapy in Sports Physical Therapy

Review written by Robin Kerr info

Key Points

  1. Manual therapy is a symptom modifying strategy that can be used to keep athletes active whilst managing injury.
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Many conditions in the musculoskeletal field (particularly sports medicine) have been overmedicalized. This has led to an over-emphasis on pharmacological and surgical interventions for conditions that could have been managed by a physiotherapist. A low cost, and safe symptom modification tool such as manual therapy may reduce medical utilization while increasing patient autonomy.

This clinical commentary paper explores the role of manual therapy in the sports therapy arena. They comment that “black and white viewpoints” on manual therapy drive polarization in the profession and that a pragmatic grey area exists, in which proper clinical reasoning regarding the use of MT can provide athletes with pain relief and effective injury management. Education and exercise are accepted as the mainstay of physiotherapy (PT) intervention. The authors point out that athletes already exercise and train at high levels and that symptom modification is a valuable component of a multidimensional injury management system.

Black and white viewpoints on manual therapy drive polarization in the profession.
Outdated narratives of “correcting faults” and nociceptive descriptors may result in athlete’s developing negative perceptions of their capabilities


The paper is based on expert opinion and commentary involving a 63-article reference list. Five main points and management examples via two case studies are provided.

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