Physio Network [Physio Discussed] Hands-on or hands-off? Rethinking manual therapy with Johnny Smith and Darren Collin
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Sep 24, 2025 Join Johnny Smith, Director of Thorpes Physiotherapy with a rich teaching background, and Darren Collin, an advanced NHS physiotherapist, as they dive into the evolving role of manual therapy. They explore how patient expectations shape treatment choices and discuss the effectiveness of manual techniques, supported by current evidence. They debate the necessity of manual therapy in modern practices, critique teaching standards in physiotherapy, and offer advice for new grads to enhance their skills. Tune in for insights into the future of this essential practice!
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Setting Shapes Manual Therapy Use
- Manual therapy use differs between NHS and private practice, with private using it more and newer NHS grads reporting less exposure.
- Pandemic-era training and departmental culture likely reduced manual therapy teaching and practice in NHS placements.
Manual Therapy Is Multifactorial
- No single mechanism fully explains how manual therapy works and views have shifted beyond joint realignment ideas.
- Manual therapy likely combines physiological effects with neurophysiological and contextual (non-specific) effects.
Combine Manual Therapy With Exercise
- Use manual therapy to reduce pain and improve movement as a bridge to exercise and education.
- Never use manipulation in isolation; combine it with exercises and advice to progress rehabilitation.