Manual Therapy: Always a Passive Treatment?

SYNOPSIS: The use of manual therapy as an intervention has garnered intense debate - often mired in a straw man argument that manual therapy is a purely passive intervention. When passive interventions are equated with low-value care, it is easy to deride manual therapy as "low-value" care. However, manual therapy describes a wide variety of different treatments. Manual therapy can have passive components and even be primarily passive in some scenarios. But manual therapy can also form an integral part of highly active treatment strategies. We implore investigators to describe manual therapy interventions used in trials in sufficient detail that can be reproduced, to help end-users of research (including clinicians) make better decisions when assessing the value of treatments. This viewpoint challenges the assumption that manual therapy is always a passive treatment of low value. J Orthop Sports Phys Ther, Epub 1 Jul 2021. doi:10.2519/jospt.2021.10330.