What is Functional Manual Therapy?

Put simply, Functional Manual Therapy (FMT) is a treatment philosophy from the Institute of Physical Art that recognizes that the body is intricately interconnected and in order to treat effectively, we as physical therapists need to acutely understand the interaction between all the body systems. FMT is a foundational part of the Institute of Physical Art’s teachings.

The big thing FMT did for me was switch my mindset from treating pain to treating function and movement. You fix the movement and most of the time you fix the pain even if the pain doesn’t immediately make sense. The focus on movement is why the word functional is so important to the FMT paradigm. We don’t just treat a condition like an average therapist following a cookbook recipe, but instead we look at the complex interaction of how your condition effects your ability to function however you want or need to.

FMT has really improved my confidence and lived up to the APTA vision statement which is to optimize movement to improve the human experience.

I think sometimes it sounds bad to say we “focus on function” because it is often confused with the idea of Activities of Daily Living (ADLs). These are the activities that are needed just to survive your day to day life like feeding, bathing, dressing, etc. In my mind function is far more than this. For one person function may be an ADL, but for others the function for them is to feel like they can compete in a high level sport, to move efficiently in yoga, or to perform in a dance competition. Since these are not considered ADLs, they are often not able to be considered functional by insurance companies for the purpose of reimbursement, but for many people they are a vital and essential part of their life.

So that begs the question, how do you treat function? We look at movement from multiple different perspectives. First are the three pillars of the IPA’s FMT approach:

• The first is mechanical capacity, can the tissue we are interested in move through the range of motion that it needs to? This can include your muscles, ligaments, joints, and even your nerves, skin, and organs.

• The second is the body’s neuromuscular function. This is the ability to contract a muscle with enough strength and endurance to successfully and efficiently perform a movement.

• The third is the body’s motor control. This is using the mechanical capacity and neuromuscular control to efficiently move or achieve and sustain a posture.

These three pillars get a LOT more complicated, but thinking in this way allows us to be thorough and assess all aspects of movement. There are other things we look at such as your general health, complicating health conditions, habits, and psychology. Once we have a complete picture we can then treat you as a whole person.

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