Was that magic? How did you do that? 



By: Mark Murphy, PT, MTC, MPT, FAAOMPT, OCS


Was that magic? How did you do that? Have you ever been asked that question by a patient? If you have, that means you did something right and your patient is impressed!

As awesome as it is to have your patient ask you that, your patient might actually want to know the reason or mechanism of how you did it. The answer might surprise them!

Multiple studies demonstrate how well manual therapy works for many conditions of the conditions you see every day such as neck pain, back pain, hip pain, shoulder pain, and most musculoskeletal issues.  Thankfully the mechanisms and reasons behind how manual therapy works so well are being looked into as well.

Manual Therapy can be defined in many different ways and can mean many things depending on what school you went to, your favorite guru, or even setting you work in. “Hands on or skilled hand movements” can be used to help joints move better, muscles knots release, or even improve mobility of a stubborn nerve.  Coming to a consensus on what manual therapy is can be challenging, but how to bill it is easy to agree on.  97140!

In the fantastic studies listed below (I realize how crazy it is to say a study was fantastic, but they really are), some of the potential mechanisms of manual therapy are discussed in detail. As an overview to possibly tempt you to read the studies or even come to Summit’s Myofascial Manual Therapy class, the biomechanical, neurophysiological, and psychological mechanisms will be briefly discussed. The time to give this topic full justice will be outside the 5 minutes you allotted to give this blog post.

The biomechanical mechanism could be more of the traditional model of loosening up a tight joint, muscle, or area where pain is present. The multiple limitations of this model are discussed, such as improvements are usually short term.

Neurophysiological mechanism is much more likely the main reason manual therapy works as well as it does. The effects on cytokines, serotonin, and endorphins as well as the supraspinal changes all are an important part of manual therapy and the great results it provides.

Psychological mechanism is very interesting and very supported in the studies. The words we use, the past experiences of the patient, and the therapist’s attitude all play a role.  

To learn more about how manual therapy works as well as it does and to put a couple more tools in your toolbox, Myofascial Manual Therapy course is a great learning option. Click here to learn more!

So next time your patient asks “How did you do that? Was that magic?”, You can say what you have in the past, which is still correct, or you could pull a new rabbit out of your hat!


 Bialosky JE, Bishop MD, Price DD, Robinson ME, George SZ. The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive model. Man. Ther. 2009;14(5):531–538.

Bishop MDTorres-Cueco RGay CWLluch-Girbés EBeneciuk JMBialosky JE. What effect can manual therapy have on a patient’s pain experience? Pain Manag. 2015;5(6):455-64. doi: 10.2217/pmt.15.39. Epub 2015 Sep 24.