Exercises of Physical Therapy vs. Manual Therapy
If you’re reading this, there’s a good chance you’ve already heard the basic difference between physical therapy and manual therapy. You’ve likely also realized that both are incredibly valuable in getting you out of pain and back into your workout groove. [If you aren’t sure of the difference, check out the video below from our Austin, TX physical therapist!]
But here’s a question we get all the time from patients just like you:
“Which exercises are physical therapy exercises, and which ones are manual therapy exercises?”
It’s a great question — especially for someone who wants efficient, high-level care and doesn’t want to waste time on the wrong thing. It is also great to be informed as a patient to better understand what you are doing with regards to improving your health.
Let’s dive into it.
First, a Quick Recap (or Watch the Video Above)
Just in case you haven’t had a chance to watch the video yet, here’s the quick and dirty version:
- Manual Therapy is hands-on treatment provided by a licensed therapist. Think soft tissue massage, joint mobilization, dry needling, and manual stretching.
- Physical Therapy Exercises involve active movement on your part. These are the strengthening, mobility, and motor control exercises designed to create long-term changes in how your body moves and feels.
What Exercises Fall Under Physical Therapy Only?
These are exercises that you, the patient, actively perform — usually with specific guidance on form, reps, and frequency. These aren’t passive. These are you doing the work, often under the watchful eye of a PT who makes sure you’re hitting the right muscles and avoiding faulty compensations. Remember, these are custom so it is not a good idea to try and look up exercises online as the wrong exercise can exacerbate your particular health problem.
- Motor Control Exercises
These are huge when you’ve got a recurring issue like back pain, shoulder impingement, or hip tightness during running. Often, the root issue isn’t strength — it’s control.
Examples:
- Bird dogs to retrain spine stability.
- Shoulder blade setting drills for impingement.
- Controlled single-leg balance drills for glute activation.
Why PT-only? Because these require repetition, progression, and feedback as your brain “rewires” to use the right muscles at the right time. These are active, and their success depends on your conscious participation. They are also increased in difficulty under the watchful eye of a PT — or they may even be decreased if your body is not reacting well to the exercises.
- Targeted Strength Training
This is not the same as just “working out.” These exercises are designed based on your evaluation — often to correct imbalances or improve endurance in stabilizing muscles. While everyone can do a few strength training exercises on their own, these in particular should only be done if prescribed by a physical therapist.
Examples:
- Glute bridges for lower back pain or runners with IT band syndrome.
- Eccentric heel drops for Achilles tendinopathy.
- Resistance band rows for shoulder rehab.
Why PT-only? A good PT doesn’t just say “do squats.” They prescribe a specific version of a squat (box squat, tempo squat, goblet squat, etc.), at a specific depth, at a specific frequency — because the goal is therapeutic, not just fitness-related. Remember, a personal trainer is focused on improving certain parts of your body, but a physical therapist is focused on helping you restore motion and get back to doing what you love without pain.
- Mobility and Flexibility Work
This often includes active movements aimed at increasing joint range. Not to be confused with stretching before a jog, these exercises are often customized to your limitations.
Examples:
- Thoracic spine rotations for posture correction.
- Hip openers using controlled articular rotations (CARs).
- Dynamic hamstring flossing for nerve tension.
Why PT-only? Mobility work needs to be dosed appropriately and tailored to your structure. Doing generic “stretch” videos from YouTube can easily lead to overstretching or missing the real issue. Remember, PT needs to address YOUR pain points, not generic ones others have listed online.
- Neuromuscular Re-education
These drills are subtle, often frustratingly so, but incredibly powerful. They’re designed to restore optimal movement patterns after injury or compensation.
Examples:
- Gentle foot intrinsic activations post-ankle sprain.
- Diaphragmatic breathing to reduce neck/shoulder overuse.
- Gentle weight shifts after knee surgery.
Why PT-only? These demand an expert eye. Many of our high-performing patients try to power through pain using brute strength — these exercises flip that mindset and ask your brain to relearn how to move more efficiently.
Now, What About Manual Therapy-Specific “Exercises”?
Here’s where it gets interesting.
Manual therapy isn’t just lying on a table while your PT does all the work. While hands-on techniques are the foundation, there are specific movements we might have you perform during or immediately after manual therapy that are considered part of the manual treatment approach.
Let’s call them “Manual Therapy-Driven Movements.”
- Mobilization with Movement (MWM)
A classic technique where the therapist applies a glide or hold on a joint, and you actively move through a painful range.
Example:
- Shoulder internal rotation with posterior glide.
- Knee extension with tibial rotation support.
Why MT-only? These movements are only effective with the therapist’s hands-on correction. You can’t replicate the joint glide yourself, so it’s not something to continue at home without that assist. Additionally, your PT has the tools to successfully make this work.
- Post-Manual Re-patterning
After we do joint work or soft tissue release, your nervous system is more “open” to changing how it fires muscles. We’ll often immediately cue very specific low-level movements to lock in the new pattern.
Examples:
- After scapular mobilization, we cue serratus activation drills.
- After cervical joint mobilization, we add deep neck flexor retraining.
Why MT-only? The timing is everything. You need to catch the nervous system in that window of plasticity right after the manual technique — this is not just a random “exercise.”
- Instrument-Assisted Movements
When using tools like a Graston instrument or percussion gun (or even Class 4 Cold Laser), we may pair this with guided active movement.
Examples:
- Running the tool over tight quads while you bend/straighten your knee.
- Working through hamstring flossing while applying gentle vibration or cold laser.
Why MT-only? These combine external inputs (manual tools) with your motion. They aren’t a “do-at-home” recipe. Without the therapist applying the right input at the right time, you risk aggravating instead of improving. Your physical therapist also will have all the tools to do this so you don’t have to worry about purchasing expensive equipment.
- Passive Range Restoration
Here’s one that gets overlooked. You may feel like stretching helps, but often what’s needed is gentle, passive restoration from a skilled therapist.
Examples:
- Passive hip joint distraction for labral irritation.
- Gentle shoulder capsule stretches for frozen shoulder.
Why MT-only? These must be done with precision. For example, blindly yanking on a frozen shoulder yourself won’t help — it may flare things up. But under the hands of a PT, passive movement can help restore the joint’s integrity safely. Additionally, your physical therapist will add more stretches as time goes on…on your own you might think doing a single stretch forever will solve your problems. However, as your body progresses, your stretches should also progress!
How Do You Know What You Need?
Here’s where most of our patients find themselves stuck:
“Should I be doing more exercises… or do I need more manual work first?”
It’s easy to fall into the “more is better” trap — more yoga, more strength, more foam rolling. But when your body is out of alignment or in pain, doing more of the wrong movement can backfire.
That’s why our approach always starts with a thorough, expert evaluation. You can’t YouTube this part. You can’t crowdsource your plan. And you definitely can’t guess your way back to full performance.
So What’s the Bottom Line?
There’s no such thing as a “manual therapy exercise” or a “PT exercise” that works in isolation.
They work together. Manual therapy often opens the door. Physical therapy exercises walk you through it.
And when you use them in the right order? That’s when magic happens. You don’t just get short-term relief. You get real change. You return to the workouts you love, stronger and smarter than before.
Find Out What YOUR Body Needs
Still unsure which type of therapy — or which type of exercise — is right for your situation? That is why you should work with a professional.
We make that easy. Book a FREE discovery session to talk with a licensed PT. We’ll help you figure out if you need more strength, more mobility, more manual intervention — or a custom mix designed just for your body.
Don’t spend another week second-guessing what your body needs. Let us help you get out of pain, move better, and return to your workouts without worry. Contact us today to work with one of our physical therapists who will create a customized treatment plan for your specific problems. Let’s work together to get you pain free and back to doing what you love!