By: Dr. Rebecca Van Heuklon, DPT, FAFS, FMR
Graduates from physical therapy school receive similar information to prepare them for working in any setting. After graduation, physical therapists can specialize in certain areas through continuing education to be able to better treat specific diagnoses or patient populations. One area where PT’s can specialize in is manual therapy. Manual therapy, or the use of hands-on techniques, is a skill that can be a beneficial and necessary component to nearly all patients who attend physical therapy. There are numerous continuing education courses that physical therapists can attend to hone their manual therapy skills and one of those is called a Functional Manual Reaction (FMR).
FMR is the technique of applying our hands to different bones on the body in order to facilitate a motion at a specific joint or joints during a functional movement. Through FMR, our hands encourage the right movement at the right joint at the right time to improve efficiency, increase muscle recruitment, and decrease pain in order to make a task easier and more comfortable.
So, what makes FMR different than other manual therapy techniques?
- FMR can be applied to ANY movement or task including walking, running, swinging a tennis racquet, squatting, going up the stairs, getting into the car, loading the dishwasher, and the list goes on.
- FMR is versatile, as it can be used for assessment, rehabilitation after an injury, or training for a specific task or sport activity.
- FMR is performed during a functional movement. Rather than being performed while passively lying down or sitting, the hands-on techniques are performed while doing the specific task, or a portion of the task, at hand. For example, if you have knee pain with walking, you might be positioned in a stride stance and weight shift while the therapist encourages movement at the foot, knee or hip.
- FMR encourages movement in all 3 planes of motion. All tasks involve movement in the forward/back plane, the side to side plane, and the rotational plane. To get the most out of FMR, movement is facilitated at the joint in all 3 planes to more authentically replicate the motion that happens during the activity.
- FMR increases proprioceptive input. Proprioceptors are receptors in the body that sense position and movement. When these receptors are stimulated, they activate the muscles to react. More proprioceptors get stimulated when an activity is performed in an upright position against gravity and while performing the actual task, which results in better muscle recruitment and better training for the muscle.
- FMR can help to enhance muscle function and muscle recruitment. Have you ever noticed how with any powerful movements, our bodies load in the opposite direction before exploding into the actual movement? Picture a golf swing, a high jump, or a pitcher throwing a ball. All of these movements involve a loading phase before the exploding phase. This hands-on approach can be used to increase loading into a position, which improves exploding out of a position, thus making movement easier and more efficient.
- FMR creates a chain reaction in the body. If the task is to reach across your body to load a plate into the dishwasher, that hand reaching creates a chain reaction of movement at the shoulder, spine, hips, knees, ankles, and every other joint in between. FMR can be used on any of the bones to create the motions needed at each joint to complete the activity efficiently and without pain or injury.
- FMR uses authentic drivers of movement such as gravity, momentum, hands, eyes, and feet. These drivers are what motivate movement in real life. The closer and specific training can be to the actual activity, the better your body is prepared for the task.
FMR is a certification through the Gray Institute that can be obtained by movement professionals who undergo a 40-week mentorship program called the Gray Institute for Functional Transformation, or GIFT. Through the GIFT mentorship program, attendees learn extensive knowledge about joint and muscle anatomy, biomechanics (the study of structure, function, and motion of the body), and how the body functions as a chain, where each link of the chain affects the other links. The knowledge gained through GIFT is then applied to be able to properly perform the FMR techniques with each individual patient. Thank you to the Gray Institute for sharing the concepts discussed in this article. If you would like to learn more about FMR and how it can help you, contact MotionWorks Physical Therapy at 920-215-2050.