Functional MobilizationTM (FM) combines active and resisted movement (PNF) with soft tissue and joint mobilization to facilitate normalization of mechanical, neuromuscular, and motor control dysfunctions. The approach was first developed by in the 1980's to treat difficult cases especially those involving complex musculoskeletal and neuromuscular dysfunctions. Consistent with its success, it now a Credential Residency Program offered by the American Physical Therapy Association (Advanced Training in Evidence Supported Clinical Reasoning and Dynamic Manual Therapy).
Functional Manual Therapy uses specific evaluation techniques to identify movement dysfunctions that contribute to pain, decreased mobility and degenerative changes. Based on the evaluative findings, specific hands on therapy techniques and movement patterns are used to restore efficient mobility of the joints and soft tissues which include muscle, nerves, organs, fascia, skin, tendons and ligaments. Once efficient mobility of the system has been restored, neuromuscular re-education is utilized to improve specific muscle initiation, strength and endurance. The final component is to improve motor control, which focuses on proper movement patterns that allow for the most efficient use of the body. This includes integration of sports specific movements, to everyday activities such as walking, lifting, active sitting, and other day to day activities.
Although physical therapists often use some manual therapy as part of a physical therapy treatment plan, it is worth clarifying the difference between physical and manual therapy. Physiotherapy typically consists of individualized exercise therapy, including active and postural or relaxation exercises, stretching, and functional exercises. Manual therapy consists of a range of hands-on techniques including muscular mobilization, joint and spine mobilization, coordination or stabilization. Here joint and spine mobilization involves low velocity passive movements within the limit of joint range of motion. This is quite different than the spinal manipulation (low amplitude, high velocity techniques) associated with chiropractors.
As a type of manual therapy, where FM shines is with difficult cases such as when the patient's condition-whether due to injury or a disease process- makes it difficult to recruit muscles appropriately, maintain posture or build muscle mass. Unfortunately, not being able to exercise compounds the patient's problem, resulting in a vicious cycle. Functional mobilization can be the link that allows the patient to return to exercise.
Dr Angela Yekrangi, DPT, COMT and founder of Cutting Edge Physical Therapy & Rehabilitation first got turned on to Functional Mobilization when she was in graduate school. For her, the wonder of the technique lies in how successfully it leverages the fact that motor function involves such a strong sensory component. FM allows the therapist to influence the sensory input and coax a more appropriate motor response. This can then be built on with more traditional physical therapy methods and augmented with a home program.
The FM training has been a great compliment to other physical therapy modalities, allowing Cutting Edge to produce superior outcomes, even with complex and difficult conditions. If you have any questions regarding the effectiveness of Functional Mobilization or whether it might be appropriate for one of your patients, please don't hesitate to contact our office.