Doctors of Physical Therapy can effectively and safely perform spinal manipulations just like chiropractors. Grade 5 low amplitude high velocity manipulations can be extremely effective in certain subgroups of individuals. They can improve range of motion, reduce pain in various ways, decrease muscle tone/guarding and improve muscle activation/recruitment. However, the exact mechanisms of how spinal manipulation truly works is still debated. But, we can say that is it more than just "realigning the spine", and my thoughts are more neurophysiological in the sense that we are providing a novel stimulus to the system which enacts the changes/benefits we see following manipulation. Research studies DO show that there are changes in the central nervous system (brain regions) immediately following spinal manipulation. I wanted to share an exert from our professor, Dr. Rob Landel PT, DPT, OCS, FAPTA, regarding physical therapists performing manipulation. "The safe application of any technique requires the use of clinical judgment, specifically, determining not only who is appropriate for the technique, but also for whom the technique is contraindicated. Adequate clinical judgment is based on knowledge of anatomy, pathoanatomy, biomechanics, pathomechanics, pathology, and a differential diagnostic process. Also, the decision of whether or not to perform a manipulation must be evidence-based, i.e. taken into account the best available evidence, the clinician’s experience, and the patient’s needs and goals. As I noted in my last post, all of these aspects are basic components of any Doctor of Physical Therapy program. Furthermore, this knowledge and clinical judgment is tested extensively through written, oral, and practical examinations, as well as put into practice during as much as one year of supervised clinical experiences. Finally, in order to become licensed in the state of California, every physical therapist must pass their licensure exam, which includes testing their knowledge and clinical judgment on manipulation, as required by the Federation of State Boards of Physical Therapy. Thus it is clear that physical therapists are well prepared to safely perform manipulation techniques, and in fact are required to be safe in their application before being allowed to practice." I am still working on my thrust manipulations, so if any clinicians have any feedback or tips, it would be much appreciated!