Manual Therapies

What are manual therapies?

Manual therapies involve the application of the hands to the body, with a diagnostic or therapeutic intent. In horses, a diverse array of manual techniques, such as touch therapies, massage, joint mobilization, and manipulation (i.e., chiropractic), have been used to improve flexibility and reduce pain and muscle hypertonicity. However, all these therapies also provide important diagnostic cues to assess musculoskeletal pain and dysfunction that is not possible with other more traditional physical examination approaches or imaging modalities.

Each technique has unique origins and different proposed biomechanical or physiological effects; however, all forms of manual therapy are characterized by applying variable gradations of manual force and degrees of soft-tissue or articular displacement.  The goal of all manual therapies is to influence reparative or healing processes within the neuromusculoskeletal system. Therapeutic effects may be generalized to the entire body by inducing relaxation or altering behavior, regional effects may include alterations in pain perception or neuromuscular control, or effects may be localized to specific tissues and cellular responses.

The challenge is in selecting the most appropriate and effective form of manual therapy to produce the desired physiological effect within an individual patient, such as increasing joint range of motion, reducing pain, or promoting general body relaxation. Anecdotally, all forms of manual therapy have reported levels of effectiveness in humans and horses. However, most claims are not supported by high levels of evidence such as randomized, controlled trials or systematic reviews of the published data.

Haussler, K.K. Equine manual therapies in sport horse practice. Vet Clin North Amer Equine Pract 2018, 34, 375-389, doi:10.1016/j.cveq.2018.04.005.

The goal of all manual therapies is to influence reparative or healing processes within the neuromusculoskeletal system. Therapeutic effects may be generalized to the entire body by inducing relaxation or altering behavior, regional effects may include alterations in pain perception or neuromuscular control, or effects may be localized to specific tissues and cellular responses. The challenge is in selecting the most appropriate and effective form of manual therapy to produce the desired physiological effect within an individual patient, such as increasing joint range of motion, reducing pain or muscle tightness, or promoting overall relaxation.