Manual Therapy: What are the keys to a successful treatment plan?

An effective manual therapy plan relies on three key elements: communication, assessment, and strategy. Clear communication between the practitioner and client is critical to ensure that goals are established, progress is monitored, and adjustments are made as needed. The assessment provides essential information about the client's current physical state. This information guides the development of an individualized treatment plan that is tailored to the client's specific needs and goals. Finally, strategy is critical for the implementation and success of the treatment plan. A well-designed strategy takes into account the client's individual characteristics and preferences and includes a structured plan for both in-person and at-home therapy that will result in progress and successful outcomes. Together, effective communication, thorough assessment, and a tailored strategy can help ensure that clients achieve their goals and maintain long-term physical health and wellness.

Communication

When a person initially reaches out to me inquiring about working together, regardless if it’s for manual therapy or otherwise, I request a 30-minute introductory phone call with each person. 

This is the first line of communication. In my 20+ years of experience, plenty of people get on my schedule, and we are a terrible fit for a variety of reasons. Whether it’s a clash of personalities, a tiger parent whose kid I’m working with, or an overly flirtatious individual, I can go on forever. 

Given these experiences, I like to try and chat casually with people to avoid wasting anyone’s investment in time and money, including my own. 

When we speak, I want to ensure that they know exactly what it is I do as a manual therapist, how I can help them with their case, help them create hierarchal goals, and what to expect in a treatment session and over time. 

Ensuring that there is an element of relatability is an important component in building a practitioner/patient relationship. This will build trust and improve communication between the two of us. 

Assessment, Education (In time)

Assessment for any manual therapy client is key to our success. In order to know where we’re going, we have to know where we’re at. 

It is my opportunity to gather prudent qualitative and quantitative information regarding the client’s joint and soft tissues. These include things like joint workspace, mechanical tension and neurological tightness found in the palpation process. 

For me, I try to not only educate clients in a theoretical manner by teaching them about concepts like joint workspace and connective tissue architecture, but I want them to physically experience and recognize these concepts as inputs or a means of communication. 

Together, the client and I are a closed loop of information, whereby I haptically manipulate their body to extract particular information about their nervous system, joint space, and connective tissue architecture. At the same time, I educate them on what I am finding and what those findings mean. 

Based on these findings, my job as a manual practitioner is to make a clinical decision to elicit a particular response. The means to elicit the desired response is carefully communicated and constrained to funnel the work and information to the appropriate level of tissue and at the patient’s perceived ability.  

After this point I will gain subjective feedback from the client about the input, I will provide my objective feedback, and we will rinse and repeat the process. 

This is a simple means of communication; I configure certain constraints, I tell you what I would like you to do with those constraints, you execute to the best of your ability, we talk about the results, and we go again. 

The assessment provides a tremendous amount of information. It is paramount to sift through it all and tease out the most consequential aspects from which we can get the most results.  

Given these elements that were trained in a treatment session elicited a desirable response, they have not fully adapted. We have merely opened up an opportunity to expand and adapt. 

Strategy

Structuring and organizing a treatment plan with training to do in between visits relies on communication and feedback. 

In order for success to be achieved by the client, no matter the goal, it is my responsibility as a practitioner to gather and interpret subjective and objective information about the person, including getting a range on their personality and psychology. Are they a busy doctor who doesn’t prioritize themselves, or are they sharp, organized, motivated, and can easily compartmentalize their day as long as the task is efficient? 

Over time, as long as my client and I have a clear line of communication and they provide me with feedback about the treatments and training, I can continuously adapt and design both to accommodate their needs. 

This is how we can provide a successful process toward achieving their goals.