Modern Manual Therapy

11/19/2025

⚠️ Motor Control vs. Resistance Training for LBP: Are you picking a side... or missing the point?

The debate is endless in the rehab world. Do we focus on tiny, targeted deep stabilizer activation (the 'Motor Control' camp) or is it time to load the system and get strong (the 'Resistance Training' camp)?

The evidence has evolved, and relying solely on one method is leaving patients on the table. If your LBP protocol hasn't been updated in the last 5 years, you need to read this.

I synthesized the latest research on the topic and created a straightforward infographic to help you cut through the dogma and apply what actually works for Low Back Pain. Spoiler alert: The answer is rarely 'either/or.'

Stop debating. Start integrating.

Click the link to see the full clinical breakdown and grab the infographic to update your practice today. Will this change the way you look at CLBP or are you already on board the load train? 👇

https://edgemobilitysystem.com/blogs/updates/motorcontrol-vs-resistancetraining-lbp

11/17/2025

Motor Control > Eccentrics? New Meta-Analysis for Rotator Cuff-Related Shoulder Pain - https://mailchi.mp/modernmanualtherapy.com/cts-7242851

11/17/2025

🔥 Reasons not to rely on diagnostic labelling for non-serious conditions in PT: - reposted via Sune Serup on my private network.

1. Most tests are not accurate enough to confirm a diagnosis.

2. The underlying condition does not necessarily need to change before the patient feels better.

3. There is often no clear relationship between the condition and the patient’s pain (also seen in asymptomatic individuals).

4. There is often no specific treatment or exercise that is superior to others for that condition.

5. Over time, central mechanisms become the primary reason people experience pain relief from exercise.

6. Over time, central mechanisms also become the primary reason people experience ongoing pain.

7. Diagnostic labelling can make people fearful.

8. Prognosis is more influenced by psychosocial factors than by the diagnosis itself.

9. Pain ≠ tissue damage

10. Pain is often more about a sensitised nervous system.

11. Pain is not something caused solely by tissue state; it is influenced by many biopsychosocial factors.

12. Imaging findings correlate poorly with pain.

13. Physiotherapists usually cannot test whether the tissue state has changed—only whether symptoms have improved.

14. When we cannot determine a tissue diagnosis, it creates confusion.

15. Even if all subjective signs point toward a diagnosis, the patient may still not actually have it.

16. In the long term, it rarely changes the exercise-based intervention anyway.

17. You cannot isolate tissues with exercise - exercise loads everything, so isolating a tissue based on a diagnosis is rarely necessary.

18. You do not need to isolate a specific structure for an exercise to work—meaning the diagnosis is not particularly important for exercise selection.

19. Most treatments rely on gradual loading and movement regardless of the diagnosis.

20. Treatment and exercise progression do not differ substantially; what we do often ends up looking similar anyway.

What do you think? I agree with the majority of this except you replace "exercise" with "treatment" as it also applies to repeated end range loading, correctives, motor control, manual therapy etc.

11/14/2025

🔥 PT Podcast Network: EMR, MTSS, & Ankle Sprains: Your Weekly PT Podcast Catch-Up - https://mailchi.mp/modernmanualtherapy.com/the-latest-podcasts-from-the-pt-podcast-network-7242797

11/11/2025

🛑Let's talk about retiring the antiquated concept of "good vs. bad" posture.🛑

Just as we understand there are no inherently good or bad exercises—only contextually appropriate or inappropriate ones—the same nuanced view applies to posture. The real win isn't a static ideal; it's about optimizing behavioral and positional variability.

The new posture is an active state defined by resilience, recovery, and movement frequency:

The Behavioral Pillars of Modern Posture

🔵Move Frequently (The 20/20 Rule): Static load tolerance is finite. Implement the 20/20 Rule: every 20 minutes, perform 20 seconds of movement, often into the opposite direction of your current posture.

🔵Move Well (End-Range Loading): Build tissue tolerance and positional confidence. Incorporate end-range loading daily to maintain and expand your usable movement capacity.

🔵Daily "Work-ins": Movement needs to be integrated, not just scheduled. Commit to at least two mini-walks during the workday, and seek out "work-ins"—simple opportunities like taking the stairs instead of the elevator—to break up sedentary time.

🔵Get 7-8 Hours of Quality Sleep: This is non-negotiable. Recovery is the biological mechanism by which tissues adapt, repair, and become resilient to load. Without adequate sleep, your best mobility drills are undermined.

We are dynamic systems designed to move and adapt. Let’s focus on load variability, frequent movement, and robust recovery to build true resilience.
What's your favorite Work-in strategy to encourage better positional hygiene throughout the day? Share it below! 👇

11/10/2025

💥 PFP Playbook Update: Stop Choosing Sides—Start Combining! 💥

The Hip vs. Knee debate for Patellofemoral Pain (PFP) is officially dead, according to the latest Level 1 evidence.

A major 2024 Network Meta-Analysis in JOSPT confirms what many of us have suspected: the COMBINED Hip & Knee focused exercise program is the undisputed champion.

📊 The Data Doesn't Lie: Combined Wins

The research shows the highest probability of being the BEST treatment for pain and function comes from an integrated approach:

Combined (Hip + Knee): 90% Probability of being the best
Hip-Focused Only: 78%
Knee-Focused Only: 65%

As modern manual therapists, our goal isn't tribalism; it's optimal patient outcomes. This NMA gives us the clinical confidence to ditch the single-culprit mentality.

💡 Your Actionable Takeaway

Ditch the Dogma: PFP is multifactorial. Stop hunting for just the weak quad or just the inhibited glute.

Prescribe Integration: Your gold standard prescription should include exercises targeting both the quadriceps (knee) and the hip abductors, extensors, and external rotators.

Educate to Empower: Use this evidence to explain to your patients why their program is comprehensive. It boosts adherence and demonstrates an evidence-based approach to the kinetic chain.

It's time to elevate your PFP management from "either/or" to "AND." This is how we move the needle in rehab.

What are your go-to combined hip and knee exercises for PFP? Drop them in the comments! 👇

11/10/2025

🤯 Stop Stretching! 2 Self-MobiliZation Hacks for Stubborn Upper Trap Tension - https://mailchi.mp/modernmanualtherapy.com/cts-7242636

11/08/2025

🔥 PT Podcast Network: Chronic Elbow Cases, Business Burnout, & Healing Adult Acne (All the Latest PT Gold!) - https://mailchi.mp/modernmanualtherapy.com/the-latest-podcasts-from-the-pt-podcast-network-7242652

11/06/2025

💡 Quick Fix for Neck & Upper Trap Tension? Think Self-Mobilization!

Ever use the Upper Thoracic Mobilization on a patient and wish they could replicate those results at home? 🤔

The typical upper thoracic mobilization technique is great for passive care, but you can’t exactly self-mobilize the T-spine that way. So, I’m sharing two simple, powerful alternatives your patients can do themselves to attack that stubborn upper quarter pain and tension.

1️⃣ Overcome Resistance (Shotgun Technique): Learn how to use light manual resistance (from your own hands!) to finally allow the neck extensors to get full cervical extension. This is a sustained hold, excellent for a upper quarter reset, especially for those chronically flexed postures.

2️⃣ Chest Opener with Isometric Contraction: This goes beyond a simple stretch. By adding an isometric neck contraction while extending and opening the chest, you isolate the movement to the upper thoracic area and avoid that compensatory low back arch. It’s a great active movement to reset posture.

These are key techniques for addressing everything from upper quarter tension to pain radiating down to the scapula. Plus, they fit perfectly into a "20-20 Rule" (20 seconds every 20 minutes) for desk workers!

What self-mobilization techniques are you currently teaching your patients for the upper quarter? Drop your thoughts below! 👇

11/05/2025

Spinal Manipulation is Not Enough. Get the Eclectic Approach (3/21-22) - https://mailchi.mp/modernmanualtherapy.com/mmttn2024-7242592

11/03/2025

Are you still arguing hands-on vs. hands-off? You're missing the point.

I see too many great PTs waste energy defending manual therapy's (MT) biomechanical effects.

A powerful new 2025 commentary from Lewis, Mintken, & McDevitt confirms what we need to shift our focus to: MT is a powerful neurophysiological tool—it helps the nervous system chill out, making the real long-term work possible.
But here’s the cold, hard truth: Treating MSK with "a bit" of MT and exercise is often LIMITED because we are ignoring the behemoths of health: lifestyle and psychosocial factors.

We're in the clinic for a few hours a week per patient.What happens during the other 165 hours? That's what drives chronic pain and recurrence.

➡️ MT's New Role:
Neuro-Modulator: Calms the system down with systemic sensory input.
Active Rehab Facilitator: Makes the active work (the long-term solution) less threatening and more compliant for the patient.

The Mandate: Become a LIFESTYLE EXPERT.

We must evolve to effectively assess and support behavioral change in areas that dwarf our clinic time:

SLEEP (Deeply impacts pain and healing)
STRESS MANAGEMENT (Cortisol modulation is everything)
NUTRITION (Systemic inflammation is the enemy)
HIGH PHYSICAL ACTIVITY (The required dosage is higher than you think: 3600+ MET-min/week)

It's time to be honest about MT's limitations as a standalone fix and become the holistic lifestyle coaches our patients truly need for lasting change.

Ready to step up your game and integrate this modern approach?

Click to get unlimited access to my flagship course and evolve your practice! 👇 Get unlimited access and earn CEUs https://edgemobilitysystem.com/pages/mmtuqlqshtag

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IASTM, Mobility, Massage and Manual Therapy Tools, ebooks, Webinars, Pain Science products, fitness and more!

11/03/2025

EXERCISE ONLY? 🛑 New RCT Proves You Need MT for Long-Term Shoulder Success. - https://mailchi.mp/modernmanualtherapy.com/cts-7242458