BackgroundTensegrity has been proposed as a unifying mechanism between structures at cellular, connective tissue and whole body level. Originating in the fields of sculpture and architecture, tensegrity has recently received increasing attention from practitioners and researchers of manual therapy. Notwithstanding this, evidence regarding the role of the tensegrity principle to manual therapy practice is lacking. ObjectiveThis qualitative study explored the conception of tensegrity amongst manual therapy practitioners and how knowledge of the physical principle of tensegrity may influence manual therapy practitioners' clinical decision-making. MethodsEight semi-structured interviews were conducted with participants from manual therapy, fascia research and/or manual therapy education fields, and analysed using grounded theory methods. ResultsData from this study indicates that tensegrity may inform clinical decision-making in manual therapy. A theory has been constructed that may help to explain aspects of manual therapy practitioners' approaches to tensegrity. Four such approaches to tensegrity were identified and elaborated on. ConclusionThis study suggests that apart from being of importance as a scientific model in the fields of architecture, engineering and biology, tensegrity may also be useful to the practice of manual therapy. Here, tensegrity may serve as a theoretical underpinning of previously conceived clinical models and subjective clinical experience, and may also inform decision-making processes by providing a biomechanical model of the human body.