Friday, March 20, 2009

Good stuff from the APTA on manipulation

This is a quick-hitter post I thought some of you out there might find interesting. I recently had a pleasant but slightly contentious discussion with a local chiropractor that wandered off into the topic of manipulation and scope of practice.

"I find it curious that PTs are so eager to criticize chiropractic, yet are equally eager to manipulate."

- Dr. Unnamed Chiropractor, DC

First of all, let me please go ahead and thank God for the ability to guide my emotional and physical restraint. Were I a younger man this is something that would have put me over the edge. Fortunately I was able to sit on my hands and restrain my tongue long enough to calmly discuss the issue with him. My talking points included:
  • The physiology of manipulation (i.e. its role as a self-perpetuating "adjustment"versus a means to normalize function).
  • The messages of self-restoration in physical therapy compared to chiropractic (I know - this is the supposed mantra of the chiropractic profession. I guess you only need a lifetime of adjustment before realizing this self-correction...)
  • Unsubstantiated claims regarding risk of a manipulation performed by a physical therapist

The conversation was brief, but I felt amazingly well prepared. Best of all...I carried it off with a sense of satisfaction that I did the right thing for our profession in sending a message to the chiro that we are well trained to perform thrust-mobilization (manipulation) and have a better model of care to support its use.

Right on the heels of this conversation, I received an email from the APTA which I strongly suggest you review if you are close to this situation. The email was from our Advocacy section and outlines some great presentations and handouts regarding PTs and manipulation. I'm a vocal critic of my organization on some issues, but man they do some great things with our dues. It is a tough check to write each year, but I feel more strongly it is the right thing to do everytime I get one of these emails. This will be a great resource for us for some time to come.


Thank you all for the great responses to my first podcast! They were greatly appreciated. Stay tuned and I've got some really good topics on the way. Also, I may be updating the format of my blog to be more user friendly and offer easier access to archived posts and my podcasts. Hang in there and we'll continue to grow!


  1. Harrison Vaughan, PT, DPTMarch 21, 2009 at 11:28 AM

    Great stuff! I did not know APTA had such an enormous wealth of information backing use of spinal manipulation by physical therapists. It certainly helps us clarify its use by PTs, especially risks and complications. The literature is continuing to provide positive results from it in highly recognized journals. I practice HVLAT as main manual therapy approach prior to exercise obtaining really good results. An evidence-based, excellent certification (Cert. SMT) for spinal manipulation is out under the direction of Dr. James Dunning, in which I highly recommend if you perform spinal manipulation to aid in justification for knowledge and skill in performing the technique.

  2. HI FOLKS,

    imagine a part of world without chiros...

    that is INDIA.