Manual Therapy

July 17th, 2012
Manual Therapy

Manual therapy is a common physical therapy treatment used by physiotherapists, osteopaths, massage therapists, and chiropractors when it comes to treating medical conditions of the musculoskeletal system. It covers a wide range of techniques that are applied to treat a variety of neuromusculoskeletal dysfunctions.

Cole Racich performing a manual knee mobilization

Manual therapy techniques are used for relieving pain and increasing mobility of the affected joints. These are categorized as stretching like massage and traction, and articulation with small-amplified joint movements.

Ryan Mullin performing a shoulder mobilization

Manual therapy also includes muscular manipulation, and joint mobilization and manipulation. When manual therapy is used to decrease stiffness of the joints, external forces are applied aimed to change the mobility or length of the connective tissue. It can be applied in a variety of ways.

Joint manipulation is manual therapy using passive movement aimed at the affected skeletal joint. It is usually characterized with the audible popping sound.

Clinical effects of this type of manual therapy includes,

  • The sacroiliac joint’s position is not altered
  • It has physiological effects on the central nervous system
  • There is a temporary increase to the patient’s passive range of motion
  • The time it takes to recover from acute back sprains is shortened
  • There is temporary relief for pain in the musculoskeletal area affected

Joint mobilization is another popular type of manual therapy. When applied to the spinal region, it is called spinal mobilization. There are five grades of joint mobilization that targets the activation of the various mechanoreceptors of the joints. The grades are applied according to the stages of resistance as well.

Physical Therapist Josh Green mobilizing the lumbar spine

Massage is a common manual therapy that aims to manipulate the superficial and the deep layers of connective tissue and muscles. Its immediate effects are to enhance muscular function, help with the healing process and promote well-being and relaxation. It can loosen tight muscles and helps in the relief of bodily aches.

Other applications of manual therapy are soft tissue mobilization, strain-counterstrain, muscle energy techniques and thrusts with high velocity and low amplitude.

Soft tissue mobilization breaks up the inelastic muscle tissue causing the relaxation for muscle tension. Manual therapy of this type is often done by placing traction on the affected area in the attempt to restore the normal texture of tissue and reduce pain.

The strain-counterstrain technique aims to correct the neuromuscular reflexes as they react in an abnormal manner. This can be used for patients with acute or delicate back problems.

Manual therapy is effective in addressing a variety of medical conditions. A certified physical therapist should always be consulted before applying any of its techniques.