The Shoulder Physio Podcast

#35: Unraveling the mechanisms of manual therapy with Associate Professor Amy McDevitt

May 21, 2024

Associate Professor Amy McDevitt discusses the evolving causal explanations of manual therapy, emphasizing the importance of understanding mechanisms and therapeutic alliance. From historical biomechanical viewpoints to contemporary neurophysiological aspects, the conversation delves into the complexities of how manual therapy works. The episode sheds light on the quest for a deeper understanding of interventions benefitting patients.

01:01:46

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Episode guests

Amy McDevitt

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Episode notes

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Quick takeaways

Manual therapy has evolved from mechanical to neurophysiological explanations, emphasizing shared mechanisms.

Contextual factors like therapeutic alliance greatly influence treatment outcomes more than previously believed.

Combining manual therapy and exercise based on patient needs enhances treatment efficacy.

Deep dives

The Evolution of Manual Therapy Mechanisms

Manual therapy mechanisms have evolved from the original belief in peripheral mechanical issues to more contemporary neurophysiological frameworks like the Biolowski model. Animal studies have provided insights into physiological mechanisms, but the translation to human patients remains challenging.

Introduction

2min

Living, Working, and Playing in Colorado

3min

Exploring Mechanisms in Manual Therapy and Exercise Interventions

12min

Exploring the Multifaceted Nature of Manual Therapy Techniques

2min

Evolution of Manual Therapy Understanding

8min

Evolving Perspectives in Manual Therapy Practices

21min

Navigating the Diverse Landscape of Manual Therapy Education

14min

In this episode of The Shoulder Physio podcast, I am joined by Amy McDevitt, an associate professor and clinician at the University of Colorado. Amy shared her perspective on manual therapy and the importance of unraveling the mechanisms behind this treatment approach.

We discussed the evolving causal explanations of manual therapy, moving beyond antiquated notions towards a more contemporary and scientifically based explanation for how it many help people in pain.

We delved into the complexities of how manual therapy works, from historical biomechanical viewpoints to more contemporary neurophysiological aspects. Amy highlighted the importance of considering contextual factors and therapeutic alliance, which may play a more significant role in patient outcomes than previously believed.

Don't miss this enlightening episode that sheds light on the intricacies of manual therapy and the quest for a deeper understanding of how interventions work to benefit patients.

Key Papers:

1. McDevitt AW, O'Halloran B, Cook CE. Cracking the code: unveiling the specific and shared mechanisms behind musculoskeletal interventions. Arch Physiother. 2023 Jul 6;13(1):14. doi: 10.1186/s40945-023-00168-3. PMID: 37415258; PMCID: PMC10327381.

2. Bialosky JE, Beneciuk JM, Bishop MD, Coronado RA, Penza CW, Simon CB, George SZ. Unraveling the Mechanisms of Manual Therapy: Modeling an Approach. J Orthop Sports Phys Ther. 2018 Jan;48(1):8-18. doi: 10.2519/jospt.2018.7476. Epub 2017 Oct 15. PMID: 29034802.

3. Silvernail JL, Deyle GD, Jensen GM, Chaconas E, Cleland J, Cook C, Courtney CA, Fritz J, Mintken P, Lonnemann ME. Orthopaedic Manual Physical Therapy: A Modern Definition and Description. Phys Ther. 2024 Mar 8:pzae036. doi: 10.1093/ptj/pzae036. Epub ahead of print. PMID: 38457654.

4. Powell JK, Lewis JS. Rotator Cuff-Related Shoulder Pain: Is It Time to Reframe the Advice, "You Need to Strengthen Your Shoulder"? J Orthop Sports Phys Ther. 2021 Apr;51(4):156-158. doi: 10.2519/jospt.2021.10199. PMID: 33789431.

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Jared on Instagram: @‌shoulder_physio

Jared on Twitter: @‌jaredpowell12

Amy on Twitter: @awmcdevittDPT

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