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Marsman Therapy
   
   
     
   
  Ideology  
 
Theoretical and practical applications of Manual Therapy Marsman have been developed and tested over thirty years by a team of Dutch Manual Therapists, including Jaap Marsman, Ben Gelevert en Herman Leferink. Gelevert and Leferink, of the Eastern Netherlands, started out as classmates in a weekly manual therapy course taught in the early 1970’s by G. Van der Bijl, Sr., a well-known Dutch physical/manual therapist. Van der Bijl was one of the first educators to begin training therapists in the techniques of manual therapy in the Netherlands. Van der Bijl’s method employed the “mobility principle” in exercising manipulation and mobilization techniques.
Of the original group of trainees, Gelevert and Leferink were the only two who persevered with the course, later to be joined by Jaap Marsman (deceased). Marsman had practical experience in the application of strong manipulations, but he had discovered that by applying a softer approach to manipulation/mobilization, similar or even better patient outcomes were achieved. Marsman also had ideas about expanding upon Van der Bijl’s methods to create an entirely new system of diagnosis and treatment of spinal dysfunction.
Marsman, Gelevert and Leferink began working together to intensively study patient movements and develop a new approach to physiotherapy treatment. The trio became more and more enthusiastic about their new methods of diagnosis and treatment and worked towards integrating them with existing mainstream physiotherapy practice.
After intensive clinical testing and experience, the team developed a new system called "Manuele Therapie Marsman" (Manual Therapy Marsman) or MTM, named for the group’s most senior member.
To promote the new manual therapy method, a professional training course was developed, initially offered in Twente and Eindhoven, the Netherlands, where the manual medical science study was established (later called SOMT). Since 1982, Manual Therapy Marsman training has been conducted exclusively in De Lutte, on the Netherlands’ eastern border, with administrative offices for MTM instruction in Denekamp, the Netherlands.
Meanwhile, the Marsman-Gelevert-Leferink team continued to refine their manual therapy system. In addition to courses concentrating on the spinal column, they have developed a course focusing on the extremities. There is a close relationship between optimal function of the cervical, thoracic and lumbar regions and function of the extremities: dysfunction in one of the spinal regions can adversely affect normal function of the extremities. MTM also offers a course on the relationship between the skull and the spinal column, and regularly conducts general comprehensive review courses.
Paramount to the effective application the Manual Therapy Marsman method is a deep understanding of the normal movement of the spinal column, including both active and passive movements. Furthermore, it is necessary to develop expertise in the recognition and diagnosis of optimal preferential movements. Limitations in movement can only be determined after establishing the patient's preferential movements. From this the practitioner can progress towards Marsman “type” determination.

The success of MTM treatment is also dependent on the practitioner’s spatial and three-dimensional understanding of the spine and from his knowledge of passive movement. Through expertise and good manual contact, application of the MTM three-dimensional mobilization technique can help patients recover lost mobility, optimize and maintain the dynamic mobility of the spinal column.
The organization Jaap Marsman founded and worked within until 1984 continues today as Manual Therapy Marsman. The two remaining lecturers, Ben Gelevert and Herman Leferink, continue to maintain and develop the MTM system that they established with Jaap Marsman over thirty years ago.
Courses represented as "based on the ideas of Jaap Marsman" or "Stichting Marsman" (Marsman Foundation) have no relationship with the above-mentioned founders of this system and the founders bear no responsibility for such courses.
 
Manual Therapy Marsman (also known in the Netherlands as Manuele Therapie Marsman or "MTM"), is a specific research and treatment method applied to correct imbalance of the spinal column and to restore spinal range of motion. Theoretical and practical applications of Marsman Manual Therapy have been developed over twenty years by renowned Dutch physical therapist Jaap Marsman (dec.) and Dutch Professors Ben Gelevert and Herman Leferink.  
 
In order to practice MTM, the therapist requires a deep understanding of the normal function of the spine in both active and passive movements. Then, the therapist must be qualified to recognize and diagnose the patient’s spinal movement preferences. Restricted movements can be ascertained once the patient’s movement preferences have been identified. Through this investigation, a patient’s preference “type” can be defined. Treatment is then applied to restore optimal function.
 
Accurate evaluation of the patient’s spinal limitation is stressed. Hands-on components of the MTM coursework focus on proper diagnosis of patient’s spinal preferences and performance of three-dimensional manipulations to restore optimal function.
 
Through extensive hands-on laboratory experience, the practitioner is trained to identify and categorize spinal alignment of each patient according to the four MTM “types” or categories of three-dimensional spinal movement. The MTM categories are:
 
Type A: Spinal flexion, right lateral flexion, left backward rotation of vertebrae
Type B: Spinal extension, right lateral flexion, right backward rotation of vertebrae
Type C: Spinal flexion, left lateral flexion, right backward rotation of vertebrae
Type D:  Spinal extension, left lateral flexion, left backward rotation of vertebrae
 
MTM considers the spinal column three functional units:
a) the lumbar-pelvic region
b) the thoracic region (including sternum and rib cage)
c) the cervical region (including skull bones)
 
Diagnosis is geared towards discovering the patient's optimal or “preferred” alignment in one of the three functional units. Therapists are trained to conduct diagnosis through use of the following steps:
 
1) Patient's history
2) Examination of spine at rest and during active movement
3) Examination of active and passive spinal movements
4) Specific tests
5) Palpation
6) X-rays and video
 
Once the patient's preferred alignment is identified, the patient’s restrictions with respect to the four Marsman types can be determined.
 
Abnormal spinal alignment is characterized by limited range of motion or "imbalance" in one or more of the three functional regions of the spine. MTM aims to restore spinal balance through application of effective but gentle spinal mobilization. Through treatment, the patient regains his own natural alignment and range of spinal movement.
 
The MTM treatment technique is fairly simple; however, performance of MTM to obtain a diagnosis is considerably more complex. MTM provides a unique perspective on the kinesiology of the body, which can be applicable to a wide range of movement therapies. MTM consists of very accurate, gentle spinal mobilizations, applied according to each individual patient’s needs; because of the gentle nature of this treatment there are not contraindications associated with MTM.
 
This is a brief overview of Manual Therapy Marsman. We continue to review and refine MTM techniques and approaches as we strive for continued improvement in the treatment of spinal ailments.