Hands-on physical therapy
What happens when stretching and exercise aren’t enough?
What a treatment decision looks like
Say reaching overhead feels difficult. We start by checking how high you can reach and what you feel. If the exam suggests a stiff joint may contribute, I may use a gentle hands-on technique, then ask you to repeat the same reach. If it feels easier, we can practice using the motion. If it feels the same, we reconsider what to try.
What a retest can tell you
A change during the visit tells us how you responded that day. What happens later also matters. I want to know whether you can put something on a shelf more easily tomorrow and whether it stays easier as you do more. A change in pain during a retest can have several explanations. It helps guide the next decision during the visit and can be checked again over time. [1, 2, 3]
How hands-on care fits with exercise
Hands-on treatment can sometimes make it easier to try a movement. Exercises then give you a way to practice or build the capacity you need between visits. Low back pain guidance includes manual therapy as one option alongside exercise. The amount and type of each depend on what helps you. Some guidelines also include hands-on care for certain kinds of neck pain. A review of spinal manipulation for chronic low back pain found effects generally similar to other recommended treatments. [4, 5, 6, 7, 8, 9]
Frequently asked questions
I feel looser on the table. What should I check when I get up?
We’d repeat the task you showed me before treatment. If reaching for a jacket was hard, try that same reach and tell me whether it’s easier, farther, or about the same.
What if I turn farther after treatment but still can’t check my blind spot comfortably?
I’d ask what still makes the driving turn hard. We can compare the turn while seated and use the usual car setup to check whether the range we gained was useful to you.
What happens if the first thing you try makes no difference?
Tell me exactly what stayed the same. I’ll use that to decide whether to change the position, check another part of the movement, or pause and reassess.
Why do you ask me to do the same step again after hands-on work?
It gives us a fair comparison. You can tell me whether the same step feels different, and I can use your answer to decide whether to keep working in that direction.
Is manual therapy the same as massage?
Some soft-tissue techniques may feel similar. Manual therapy also includes techniques that gently move joints. In a PT session, I choose what to try based on the exam and the activity you want to improve.
Will it hurt?
Tell me how a technique feels as we go. I can change the pressure or position, try a different approach, or stop. You can decline any technique. Temporary soreness can occur after hands-on treatment. [10]
What if the relief wears off?
Tell me when it wears off and what you were doing at the time. We can use that information to adjust the plan and look for changes that carry over to your daily life.
Does the free evaluation include treatment?
The free visit is a 30- to 45-minute hands-on evaluation to understand what may help and whether we’re a fit. If you decide to continue, one-on-one treatment is $200 per hour.
How do you know if the hands-on work is doing anything?
We pick a movement that matters to you and test it before treatment. I make one change and have you try the same movement again. Your feedback helps me decide whether to build on it, adjust the technique, or try something else in that same visit. That’s what I mean by test, treat, and retest.