The current article explores the question of how it is possible to create professional distance in the daily routine of manual therapy -despite the physical contact-and at the same time preserve the limits and needs of others but also one's own. It is about finding the right relationship between closeness and distance, and not only in the spatial sense. The authors describe how empathy enables establishment of an inner contact and how, with the help of professional distance, the crossing of physical boundaries is balanced. The appropriate therapeutic spacing in manual treatment must always be found anew, depending on the situation. If the personal boundaries of physical closeness are crossed carelessly, personal integrity is harmed. An overview of the corresponding criminal offenses and the frequency of sexualized violence in the population is given. Furthermore, the aspects that must be considered when dealing with traumatized patients are discussed. Finally, the learning of professional closeness and distance in manual therapy training is discussed.