The Foundations in Manual Therapy: Voice and Swallowing Disorders curriculum guides the learner through a series of in-person and online courses that culminate in a certification program (coming soon). While some clinicians find that the Introductory class provides sufficient skills to meet their patients' needs better, others find that deepening their learning offers greater value and confidence. The available courses include in-person and online options, with both short and long formats available. The Deeper Dives video courses give you small bites of information to apply in your practice. In contrast, the long-format courses supply you with sufficient skill to carry the work over into an entire treatment routine. For those seeking a more bespoke experience, private mentoring is available for all courses or to refine your existing skillset.
Manual therapy has been included in the literature impacting the speech-language pathologist (SLP) since at least 1980 (Aronson), and researched since 1993 (Roy and Leeper). Since that time, manual therapy has been expanded into dysphagia, oral motor-related issues, trismus, and many more areas. Though traditionally cited from various tissue pathology-based models, leaving a mildly uncertain path for determining the exact mechanisms of action underpinning the work, newer research has begun to view it as a multifactorial intervention, moving beyond the “issues-in-the-tissues” narratives. Manual therapy often appears awkward, and even outside the scope of practice of the SLP, to some. However, the breadth of current research should place it at the center of the SLP’s intervention choices. If you wish to look over some of the references used to support this work and training, please click here.
Communication is uniquely taught throughout the Foundations Seminar courses, in a manner seldom used in therapeutic environments. Traditionally, manual therapy is presented as a skill-based intervention, one that the therapist is expected to master, making them capable of making diagnostic and treatment decisions based on the best available evidence. However, the patient's role within this model is typically one of subservience. They don’t know what we know, and easily defer decision-making to us. Yet, since the 1990s, a power balance has been established by evidence-based practice standards, with significant changes across the spectrum of healthcare…except in manual therapy. Manual therapy continues to be taught and enacted in a skewed power relationship arrangement. This needs to change. What we’ve accomplished is to set in place one model for power sharing (shared decision-making), where the patient plays an equal role in clinical decision-making, thereby improving patient buy-in and ensuring relevance to the patient’s individual and unique needs and preferences. This model, situated side-by-side with a slow, relatively gentle form of treatment, allows the pressure on the clinician to feel the need to be an expert to be lessened, especially for those new to manual care.
Walt Fritz has been teaching manual therapy to SLPs (and related professions) since his first workshop in Chicago, Illinois, in 2013. Walt has taught thousands of SLPs worldwide. Please take some time to look over the many podcasts Walt has been a part of, the research list to support his work, and the recent paper he published, “The mechanism of action for laryngeal manual therapies: the need for an update.” Take some time to view the new Peer-to-Peer Mentoring video series to learn how other clinicians have adopted this approach to their practice. Lastly, feel free to contact Walt with questions.
Care to read what feedback seminar participants had to say about a recent class? You can read scans from a recent class here.
Manual therapy as seen through the lens of FEES (Fiberoptic Endoscopic Evaluation of Swallowing).
This video was recorded on my recent teaching trip in Mumbai and Bengaluru, India, in November 2025. Demonstrations such as these are not intended to prove a therapeutic effect. However, they do show that when we perform manual therapy on the laryngeal region, there are direct effects on relevant internal structures. Modern mechanisms-of-action narratives for manual therapy have transcended the view that change occurs solely as a result of the clinician's expertise and have shifted the onus for change onto the patient. If manual therapy is combined with functional efforts on the patient's part, and the manual therapy input replicates or somehow connects with those issues, these modern perspectives on manual therapy impacts allow us to see how therapeutic benefits can result from such exposure.
For more information on this work, please refer to https://www.waltfritz.com/
Here are a few sources of the updated mechanism of action for manual therapy:
1. Bialosky, J.E., Cleland, J.A., Mintken, P., et al. (2021) The healthcare buffet: preferences in the clinical decision-making process for patients with musculoskeletal pain. Journal of Manual & Manipulative Therapy.
2. Geri, T., Viceconti, A., Minacci, M., Testa, M., & Rossettini, G. (2019). Manual therapy: Exploiting the role of human touch. Musculoskeletal science & practice, 44, 102044.
3. Keter, D. L., Bialosky, J. E., Brochetti, K., Courtney, C. A., Funabashi, M., Karas, S., Learman, K., & Cook, C. E. (2025). The mechanisms of manual therapy: A living review of systematic, narrative, and scoping reviews. PloS one, 20(3), e0319586.
4. Kolb, W.H., Wallace McDevitt, A., Young, J. et al. (2020) The evolution of manual therapy education: what are we waiting for?, Journal of Manual & Manipulative Therapy, 28:1, 1-3.
5. Roy, N., Dietrich, M., Blomgren, M., Heller, A., Houtz, D. R., & Lee, J. (2019). Exploring the neural bases of primary muscle tension dysphonia: a case study using functional magnetic resonance imaging. Journal of Voice, 33(2), 183-194.
https://youtu.be/n_Wbi1KD45g