Manual therapy techniques are skilled hand movements intended to improve tissue extensibility, increase range of motion, induce relaxation, mobilize or manipulate soft tissue and joints, modulate pain, and reduce soft tissue swelling, inflammation, or restriction. Manual therapy began as manipulative therapy and has evolved through the years with the influence of many professionals. Manual therapy that PTs use now is a combination of techniques designed to affect muscles, ligaments, tendons, and connective tissue, in order to improve the impairment and functional limitations of the patient. These techniques include the following:

Manipulative therapy can be dated back to Hippocrates, with reference to spinal manipulation, and likely even before that time. Spinal manipulation by bone setters was popular among the general population and went in and out of favor with the medical profession, depending on current medical concepts of the time. In the 1800s, physicians and newly organized professional chiropractors practiced and taught the notion that one needs to maintain a normal musculoskeletal system to maintain health. They believed that vertebral alignment or mal-alignment related to function or dysfunction. Chiropractic care became popular with the end of WWII, and then years later in 1958, physical therapy grew, and this growth threatened chiropractors.

Physical therapy began in the early twentieth century, with therapists labeled as “reconstruction aides” during World War I. This term later evolved into professionalized “physical therapists”, with significant help from Mary McMillan. By the 1950s, PTs from around the world were becoming more prominent in their teachings. Physicians and PTs continued to promote manual and manipulative therapy, with major influences from many professionals, including the following: