Manual Therapy Mechanisms

Teaching manual therapy as a window of reduced sensitivity may make patients more willing to use active strategies. Clinicians may overestimate how much manual techniques can directly change tissue structure. Modern manual therapy explanations should emphasize neurophysiological mechanisms rather than putting bones back into place. Manual therapy likely works through nervous system effects that influence pain and movement. Bone-out-of-place explanations can encourage dependency and fear. Repeated manipulation is not considered likely to create meaningful tendon or ligament laxity in typical adult clinical contexts.