Manual therapy has become to some degree controversial in recent years. Manual therapy generally covers the therapy approaches of mobilization and manipulation. This conflict is predicated surrounding the not having enough good research which actually shows it improves outcomes. That will not mean that this doesn't help, it really suggests that the quality of the analysis which backs up its clinical application is of low quality. The other concern that is making it debatable is if it will work, then how exactly does it work. Previously it had been the theatrical cracking noise as a joint is snapped back into place. Most of the data currently points too that isn't exactly how it improves outcomes and it almost certainly works through some type of pain disturbance strategy giving the sense the pain is much better. None of this is entirely clear and much more scientific studies are ongoing to try to handle this issue. This poses a issue for health care professionals who use these types of mobilization and manipulation clinical skills and want to make judgements on the way to help out their patients clinically but still always be evidence based with what they do.
A freshly released episode of the podiatry chat show, PodChatLive attempted to take care of these types of difficulties with regards to mobilization and manipulation for foot problems. In that edition the hosts chatted with Dave Cashley who provided his personal expertise both from his many years of clinical work and his own study on manipulation and mobilization. Dave's research has recently been on its use for Morton's neuroma and it is coming across as promising. He also voices his point of view on a number of the criticisms that have been aimed at mobilization and manipulation. He is a podiatrist plus a respected worldwide presenter and teacher. David 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 literature in recent times. During his career, he has worked alongside professional athletes, elite athletes, world champions, international dance troups as well as the British armed service.