Manual therapy is becoming somewhat debatable in recent years. Manual therapy commonly covers the physical therapy approaches of manipulation and mobilization. That controversy is based surrounding the absence of good research that really reveals it improves outcomes. That will not imply that it doesn't help, it simply shows that the level of the analysis which advocates for its usage is of low quality. Another challenge which is making it contentious is if this will work, then so how exactly does it work. In the past it had been the spectacular cracking noise like a joint is put back into place. Lots of the evidence currently demonstrates that that isn't exactly how it improves outcomes and it quite possibly works via some form of pain disturbance method offering the impression that the pain is improved. None of this is entirely clear and much more research is ongoing in an attempt to deal with this issue. This poses a dilemma for health professionals who use these types of mobilization and manipulation techniques and want to generate options on how to help their patients clinically but still always be evidence based with the things they do.
The latest episode of the podiatry live, PodChatLive tried to consider these sorts of challenges with regards to manual therapy for foot conditions. In this chat the hosts chatted with Dave Cashley who offered his personal experience both from his a great deal of clinical practice and his own study on manipulation and mobilization. Dave's studies have recently been about its use for Morton's neuroma and it's coming across as promising. He also voices his point of view on a lot of the criticisms which have been directed at mobilization and manipulation. He is a podiatrist and a respected worldwide speaker and teacher. He is a fellow with the Royal College of Physicians and Surgeons and has now published a number of publications on podiatric manual therapy in the journals in recent years. Throughout his career, he has worked with professional athletes, elite athletes, world champions, worldwide dancing troups and the British armed forces.