This illustration of a person and a composite of what they see illustrates the idea that a person's point of view determines what they see; in this article that principle is applied to modern manual therapy.

Your point of view determines what you see. It’s often obvious that you might need to adjust your physical vantage point in order to gain a new perspective—but how practiced are we at adjusting and expanding our mental vantage point? This article will help you upgrade your points of view related to modern manual therapy.

Being in Florida, we have a pond behind our house that often harbors all sorts of wildlife—large birds, alligators, turtles and the like. Anytime one of us spots something interesting, there is a back and forth to direct the other to see it:

“It’s to the left of the tree. Oh no, maybe to the right of the tree from where you are? Maybe it’s hidden behind the tree, move toward me.”

Eventually, the easiest way to spot it is to stand right where the seer is and get the same point of view. 

Three Primary Points of View in Modern Manual Therapy

As manual therapists, we have the privilege of working with one of the most fascinating and complex forms on the planet, the human body, and it deserves, even demands, a more nuanced and multi-faceted point of view.

There are myriad perspectives on the inner workings of the body that we could draw from; to simplify, we’ll categorize them into three primary points of view: structural, functional and energetic.

These three categories act as lenses through which you could view and address the body. Our intention here is to offer a more dynamic, integrative point of view that honors the complexity of the body and enables us to address it more comprehensively and effectively.

To enhance your point of view, it is helpful to first notice your current vantage point. How do you view the body and your work with it? Your specific point of view will be directed and shaped by your training.

The Structural Lens

While many trainings are somewhat integrative, the structural level is the most common place to start, particularly from a Western approach. The structural lens holds as primary the physical components: the tissues, muscle, fascia and chemical building blocks. From this perspective, there is an emphasis on assessing and treating these structures as a way of positively impacting the whole.

This structural approach has us focus on manipulating tissues, often with the intention of relaxing or releasing them. Manual therapists are taught many effective treatments that deal with the body’s tissues and structures, and these techniques have undoubtedly helped millions of massage clients reach their goals for relaxation, pain reduction, sports performance and alignment issues.

Luckily, as soon as we think we know all there is to know about the body, it graciously reminds us that we still have plenty to learn: The seemingly simple muscle pain that won’t resolve, the biomechanical pattern that refuses to shift, the trigger point that keeps returning to haunt your every session. These little breadcrumbs, rather than defeating us, remind us to keep plumbing the depths of the truths and wonders of the dynamics of the body. This endeavor leads us to explore the other two lenses:  functional and energetic.

The Functional Lens

The functional lens observes the body in motion, seeing the tissues not just as static structures but as vehicles for force generation, transfer, and absorption. This lens recognizes that we are not just interested in relaxing a body on the massage table, but rather in facilitating its movement through the world.

Viewing the body through a functional lens, we may begin to observe structural patterns differently. Dense tissue may be that way because of how it has been pulled on in function. Scoliotic patterns may arise because of functional imbalances. 

When observing structure, we should keep in mind two functional realities: The body is doing its best to dynamically balance all its parts in relationship to gravity, and does not exist daily on a massage table; rather, the body exists in motion in its particular environment. Along these same lines, the body organizes its structure in a way that maximizes efficiency in doing what you do most of time; i.e., if you sit a lot, the body tissues organize to make sitting easy and efficient. These two functional realities are what shapes the body’s structure.

When we understand function, it therefore informs how we assess and address structure.

You may be thinking, “I learned muscle actions and joint movements in massage school, is that what you mean?” Well, not quite.

Isolated concentric muscle action (what most kinesiology curriculums teach) is but a small piece of the functional pie. Functionally, eccentric contraction (the muscle lengthening while producing force) is more important than concentric contraction when we consider the body in gravity.

The body works as a connected whole; every joint and muscle moves through three planes of motion, generating and dispersing force with every movement. In our current massage education models, this is not so much ignored but never taught.

For example, you were probably taught that the hamstring flexes the knee. It does, of course, when you’re lying prone on a massage table. However, if you used it for that when standing with your feet on the ground, you’d land flat on your back when you contracted your hamstrings. 

When myofascial units aren’t able to concentrically and eccentrically load synergistically through all three planes of motion, the nervous system starts to tighten muscles and tissues to protect itself. This creates inefficient movement patterns.

For instance, if your client sits at a desk or drives for a few hours a day, the quadriceps, hip flexors and adductors can become inhibited, causing a lack of hip extension when walking. Once this happens, the posterior lower leg muscles will not get fully eccentrically loaded when walking and will start to tighten up. This lack of hip extension is a major cause of chronically tight calves and plantar fascia issues. –

Once you learn to view the body through a more dynamic functional lens, these relationships help inform your structural work to facilitate functional improvement.

The Energetic Lens

From some points of view, all of this is meaningless if we do not consider the energetic body. Traditional healing systems such as Ayurveda and Chinese Medicine consider the physical and functional to be a manifestation of what’s occurring on the energetic level. Various systems include their own energetic anatomies such as meridians in Chinese medicine or Chakras in Ayurveda and many more.

We often call this the informational level because it seems to provide the blueprint for our expression. The term biofield science is becoming more popular as the scientific support for the presence and impact of energetic fields is growing. 

We integrate a number of energetic modalities into our structural and functional work, and there is always more to discover. I (Lynn) remember the first time I received Pranic healing. I didn’t really have any preconceptions about what I might feel and what the results would be.

During and after the session, I was amazed at how loose and relaxed my body was, and that a lot of my chronic back tension was relieved without any physical contact from the practitioner. I have taught energy therapies for over 20 years and I can’t imagine not having this approach for self-care now.

The Modern Manual Therapy Approach

Since the body exists on these three levels—structural, functional and energetic—it stands to reason that our approach to facilitating health and wellbeing would take each level into consideration in both assessment and treatment. There are so many great trainings our there for us to explore as therapists.

If you want more consistent, efficient and comprehensive results, consider branching out into the functional and energetic trainings available to you and integrating those perspectives into your structural work.

Ann and Lynn Teachworth

About the Authors

Ann and Lynn Teachworth integrate 40-plus years of expertise in structural integration, functional biomechanics, and energy medicine to help make good therapists great. They teach advanced continuing education for massage and manual therapists through their company Trunamics. Find their in person and online trainings at