HOW DOES MANUAL THERAPY WORK?

Physiotherapy aims to help patients recover from an injury or surgery or

address a muscle imbalance. Manual therapy techniques may assess why a

muscle is not functioning as it should or assist in restoring joint mobility. Learn more

about these sessions.

What Is Manual Physical Therapy?

A physiotherapy technique involving the hands, manual therapy does not use any

outside devices for treatment.

The hands can provide pressure to muscles and connective tissue, with emphasis on

the back and neurovascular system, or manipulate joints to restore functionality. The

goal is to address the root of musculoskeletal pain and provide patients with a degree of

relief.

Although, on the surface, manual therapy appears similar to massage, techniques take

biomechanical, neurophysiological, and psychological factors into account. Techniques

vary based on the area being targeted.

With joints, the therapist focuses on articular structures to improve mobility and range of

motion for certain musculoskeletal conditions, and the neurovascular system

and neurovascular bundles are targeted. With muscles and connective tissues, manual

stress is applied to these areas.

In conjunction with other physiotherapy techniques, manual therapy can:

 Address sources of pain and discomfort related to posture, muscle function, or

movement

 Help improve mobility for stiff joints and muscles

 Assist with reducing muscle tension to help a patient move without pain

 Offer a solution to manage chronic conditions like back pain or a joint issue.

Manual Therapy Techniques

Therapists employ manual techniques for a three-fold effect: Biomechanical to help

improve and remodel tissues, psychological for enhanced pain management, and

physiological to increase mobility through reduced tension, stiffness, and pain.

Collectively, these techniques help to relax tight muscles in the back and around joints

to lessen the pain response and improve flexibility. These techniques fall into a few

categories:

 Soft Tissue Work: Applying pressure to lessen tension, improve

circulation, reduce inflammation and pain, and decrease bands of scar and fibrous

muscle tissue. For patients, this can be a combination of stretching and pressure

within a particular area. Soft tissue techniques can be applied to the muscles,

tendons, and nerve bundles.

 Mobilization and Manipulation: Blends speed, force, and distance to restore

mobility to bones and joints. This combination helps reduce pain, improves joint

flexibility, and targets restricting the movement of stiff or tight tissue.

 Strain/Counter-Strain: Targets postural and other structural issues related to

neuromuscular reflexes.

 Muscle Energy Techniques: Cause a voluntary contraction against an opposing

force to help lessen stunted muscles and improve joint mobility. Patients assume a

more active role compared to other manual therapy techniques.

Within this spectrum, standard manual therapy methods include:

 Massage

 Active release

 Traction

 Trigger point therapy

 Passive and assisted active range of motion

 Lymph drainage

 Soft tissue mobilization

 Stretches focusing on the muscles, fascia, and joints

Treatment with Manual Therapy

Before proceeding with manual therapy, a patient’s injury or condition will be thoroughly

assessed, including bones, muscles, and neurovascular aspects. This treatment is more

common to address:

 Back and spine conditions

 Neck pain

 Hand and wrist injuries

 Elbow and shoulder issues

 Hip issues

 Knee conditions

 Ankle and foot issues

 Injuries stemming from an accident

 Occupational injuries

 Muscle tension and spasms

Manual therapy is very effective for several conditions but not all

physiotherapists have the training or experience to perform all the treatments

mentioned. Talk to your therapist about what they can offer you.