What is Orthopedic Manual Physical Therapy?
What is Orthopedic Manual Physical Therapy?
Manual therapy is 'hands-on' treatment provided by an orthopedic manual physical therapist to decrease pain and improve motion of the targeted neuromusculoskeletal structures inside a patient's body.
Orthopedic Manual Physical Therapy (OMPT) has been defined as follows:
"Orthopaedic Manual Physical Therapy is a specialised area of physiotherapy / physical therapy for the management of neuro-musculoskeletal conditions, based on clinical reasoning, using highly specific treatment approaches including manual techniques and therapeutic exercises. Orthopaedic Manual Physical Therapy also encompasses, and is driven by, the available scientific and clinical evidence and the biopsychosocial framework of each individual patient." - International Federation of Orthopaedic Manipulative Physical Therapists
"OMPT is any 'hands-on' treatment provided by the physical therapist. Treatment may include moving joints in specific directions and at different speeds to regain movement (joint mobilization and manipulation), muscle stretching, passive movements of the affected body part, or having the patient move the body part against the therapist’s resistance to improve muscle activation and timing. Selected specific soft tissue techniques may also be used to improve the mobility and function of tissue and muscles. Orthopaedic manual physical therapists treat acute and chronic symptomatic conditions in body regions including the head, neck, back, arms and legs. Early, consistent and skillful manual physical therapy, combined with exercise and patient education, is central to the OMPT therapist’s practice." - American Academy of Orthopaedic Manual Physical Therapists
However, an updated definition of Orthopedic Manual Physical Therapy has recently been proposed [1]:
"OMPT is a subspecialty of physical therapy featuring a systematic active approach for the management of a broad spectrum of physical disorders. Based on a patient-centered advanced clinical reasoning model taught in fellowship training, OMPT has key distinguishing characteristics that include expertise in hands-on iterative examination and treatment strategies inclusive of thrust and non-thrust manipulation. Essential to OMPT is a focus on continuous reassessment through all aspects of care, synergistic application of carefully designed and dosed exercise, and a patient-centered long-term mindset driven by the available scientific and clinical evidence, and the biopsychosocial framework of each individual patient."
What are some Orthopedic Manual Physical Therapy techniques?
Orthopedic Manual Physical Therapy techniques may be applied at varying speeds and amplitudes, and they subsequently fall into various broad categories:
Soft Tissue Mobilization
Massage
Joint Mobilization
Thrust Manipulation
Spinal Manipulation
Neuromobilization
Manual Stretching
Muscle Energy (Activation) Technique
Mobilization with Movement
Instrument-Assisted Soft Tissue Mobilization (such as Dry Needling)
What does "Orthopedic" mean?
The term "Orthopedic" refers to the treatment of the neuromusculoskeletal system: the spine, nerves, muscles, tendons, ligaments, bones, cartilage, and related structures that provide the body with sensation, support, or movement.
What is the difference between a Physical Therapist and an Orthopedic Manual Physical Therapist?
Typically, an Orthopedic Manual Physical Therapist is a Physical Therapist who has received additional training in hands-on manual therapy techniques beyond the instruction in the Doctor of Physical Therapy program, which requires 7 years of education. However, graduates of a Doctor of Physical Therapy program without any additional training can technically refer to themselves as orthopedic manual physical therapists if that's the area they choose to focus on in their practice.
What are the different levels of training for Orthopedic Manual Physical Therapists?
1. Physical therapists who choose to focus on manual therapy in their practice without additional training beyond graduating from a Doctor of Physical Therapy program. Since the fundamentals of orthopedics and manual therapy are taught in Doctor of Physical Therapy programs, a graduate of this program can technically claim to be an orthopedic manual physical therapist if that's the area they choose to focus on.
2. Physical therapists who become certified in orthopedic manual physical therapy after graduating from a Doctor of Physical Therapy program. Many certificate programs are available that offer a few weekend labs over the course of several months where participants learn hands-on techniques and then pass an examination (or series of them) to earn a Certification in Orthopedic Manual Physical Therapy.
3. Physical therapists who graduate from a fellowship program specializing in orthopedic manual physical therapy after graduating from a Doctor of Physical Therapy program. To become a Fellow of the American Academy of Orthopedic Manual Physical Therapists (AAOMPT), a physical therapist must complete 2-3 years of full-time coursework after completing the 7 yrs of a Doctor of Physical Therapy program.
Fellowship training includes achieving expertise performing advanced hands-on techniques, synthesis of current research, and demonstration of a scientific, evidence-based approach to patient management. Fellows are the leaders of the physical therapy profession in clinical practice and clinical research and are considered clinician scientists due to the extensive educational requirements of the Fellowship Program.
Fellowship-trained physical therapists have demonstrated greater diagnostic accuracy and superior treatment outcomes compared to non-fellow physical therapists. A study by Rodeghero et al [2] noted that physical therapists trained in a Fellowship Program had demonstrated greater changes in patient function, efficiency of treatment, and patient outcomes than physical therapists not trained in a Fellowship Program. Therefore, when you choose a physical therapist with Fellowship training, you are likely to experience better results over fewer visits than you would with a physical therapist without this additional education. You can find a fellow here.
Further Information on Orthopedic Manual Physical Therapy
Click on any of the following links for more information:
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Dr. Damon Bescia is a fellowship-trained Doctor of Physical Therapy, board certified in orthopedics and sports physical therapy, who specializes in Orthopedic Manual Physical Therapy and serves Naperville and its surrounding communities by way of his Concierge Practice, providing private one-to-one orthopedic manual physical therapy for his clients. For more information, please visit https://www.napervillemanualphysicaltherapy.com.
1 Jason L Silvernail, Gail D Deyle, Gail M Jensen, Eric Chaconas, Josh Cleland, Chad Cook, Carol A Courtney, Julie Fritz, Paul Mintken, Elaine Lonnemann, Orthopaedic Manual Physical Therapy: A Modern Definition and Description, Physical Therapy, Volume 104, Issue 6, June 2024
