Abstract
Background
Musculoskeletal injuries are a common and debilitating problem for athletes, impacting their performance, participation, and overall well-being. Manual therapy, a hands-on approach involving joint mobilization and soft tissue manipulation, is frequently used as part of the rehabilitation for these injuries. However, the effectiveness of manual therapy for athletic musculoskeletal injuries has not been adequately explored in existing literature.
Purpose
This systematic review and meta-analysis aimed to evaluate the impact of manual therapy on pain, function, and return to sports in athletes with musculoskeletal injuries. This systematic review and meta-analysis aimed to evaluate the impact of manual therapy on pain, function, and return to sports in athletes with musculoskeletal injuries.
Methods
A comprehensive search was conducted across six electronic databases (Medline, EMBASE, CINAHL Complete, Web of Science, Scopus, and SPORTDiscus) from inception to March 11, 2024. Randomized controlled trials (RCTs) comparing manual therapy to controls for adult athletes with musculoskeletal injuries were included. Risk of bias was assessed using the Cochrane RoB 2.0 tool. The primary outcomes were pain and function, while the secondary outcome was time to return to sports. Pooled data was presented as the standardized mean difference with 95% confidence intervals (CIs) using a random effects model.
Results
Nine RCTs met the inclusion criteria, with seven included in the meta-analysis after the risk of bias assessment. The studies involved 378 participants from eight countries, covering 13 sports and various manual therapy techniques. The meta-analysis revealed a significant reduction in pain intensity immediately post-intervention (pooled SMD = -2.47; 95% CI, -3.64 to -1.30; P < 0.05; I2 = 94%). However, no significant differences were found in pain reduction for short-term assessments. For function, manual therapy showed no significant improvement immediately post-intervention (SMD = 0.72; 95% CI, -0.15 to 1.59; P > 0.05; I2 = 84%). However, manual therapy showed a significant improvement in the short term (SMD = 1.33; 95% CI, 0.12 to 2.53). Only one study measured time to return to sports, which showed significant difference between multimodal physiotherapy treatment including manual therapy (12.8 weeks) and exercise therapy group (17.3 weeks).
Conclusion(s)
Manual therapy is effective in providing immediate pain relief and short-term functional improvements for athletes with musculoskeletal injuries. However, the high heterogeneity and risk of bias across studies necessitate cautious interpretation of the results. Further high-quality RCTs with long-term follow-up are needed to confirm these findings and optimize manual therapy protocols for athletic rehabilitation.
Implications
This study suggests manual therapy benefits athletes' musculoskeletal injuries by reducing pain and improving short-term function. However, inconsistent long-term evidence and study heterogeneity require further high-quality research (RCTs with long-term follow-up and standardized protocols) to optimize clinical practice and improve athlete recovery.
Musculoskeletal injuries are a common and debilitating problem for athletes, impacting their performance, participation, and overall well-being. Manual therapy, a hands-on approach involving joint mobilization and soft tissue manipulation, is frequently used as part of the rehabilitation for these injuries. However, the effectiveness of manual therapy for athletic musculoskeletal injuries has not been adequately explored in existing literature.
Purpose
This systematic review and meta-analysis aimed to evaluate the impact of manual therapy on pain, function, and return to sports in athletes with musculoskeletal injuries. This systematic review and meta-analysis aimed to evaluate the impact of manual therapy on pain, function, and return to sports in athletes with musculoskeletal injuries.
Methods
A comprehensive search was conducted across six electronic databases (Medline, EMBASE, CINAHL Complete, Web of Science, Scopus, and SPORTDiscus) from inception to March 11, 2024. Randomized controlled trials (RCTs) comparing manual therapy to controls for adult athletes with musculoskeletal injuries were included. Risk of bias was assessed using the Cochrane RoB 2.0 tool. The primary outcomes were pain and function, while the secondary outcome was time to return to sports. Pooled data was presented as the standardized mean difference with 95% confidence intervals (CIs) using a random effects model.
Results
Nine RCTs met the inclusion criteria, with seven included in the meta-analysis after the risk of bias assessment. The studies involved 378 participants from eight countries, covering 13 sports and various manual therapy techniques. The meta-analysis revealed a significant reduction in pain intensity immediately post-intervention (pooled SMD = -2.47; 95% CI, -3.64 to -1.30; P < 0.05; I2 = 94%). However, no significant differences were found in pain reduction for short-term assessments. For function, manual therapy showed no significant improvement immediately post-intervention (SMD = 0.72; 95% CI, -0.15 to 1.59; P > 0.05; I2 = 84%). However, manual therapy showed a significant improvement in the short term (SMD = 1.33; 95% CI, 0.12 to 2.53). Only one study measured time to return to sports, which showed significant difference between multimodal physiotherapy treatment including manual therapy (12.8 weeks) and exercise therapy group (17.3 weeks).
Conclusion(s)
Manual therapy is effective in providing immediate pain relief and short-term functional improvements for athletes with musculoskeletal injuries. However, the high heterogeneity and risk of bias across studies necessitate cautious interpretation of the results. Further high-quality RCTs with long-term follow-up are needed to confirm these findings and optimize manual therapy protocols for athletic rehabilitation.
Implications
This study suggests manual therapy benefits athletes' musculoskeletal injuries by reducing pain and improving short-term function. However, inconsistent long-term evidence and study heterogeneity require further high-quality research (RCTs with long-term follow-up and standardized protocols) to optimize clinical practice and improve athlete recovery.
| Original language | English |
|---|---|
| Publication status | Not published / presented only - 29 May 2025 |
| Event | World Physiotherapy Congress 2025 - Tokyo, Japan Duration: 29 May 2025 → 31 May 2025 https://wp2025.world.physio/ |
Conference
| Conference | World Physiotherapy Congress 2025 |
|---|---|
| Abbreviated title | WPC2025 |
| Country/Territory | Japan |
| City | Tokyo |
| Period | 29/05/25 → 31/05/25 |
| Internet address |