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Manual Therapy

Manual Physical Therapy:
Hands-On Treatment Techniques

Manual therapy is a hands-on physical therapy approach to relieve pain, increase range of motion (ROM), and improve circulation and muscle engagement. Without the use of machines, physical therapists use the latest techniques to stretch, massage, strengthen and mobilize soft tissue and joints. 

Our physical therapists are highly qualified when it comes to guiding your recovery. Coordinating your path to pain free movement may involve a combination of hands-on physical therapy movements and high-tech equipment such as electrical stimulation and blood-flow restriction training. We are trained to treat and reduce pain quickly, using precise manual therapy techniques performed by a neuromuscular expert.

Describing Manual Therapy

Manual therapy is a clinical hands-on physical therapy technique, using skilled and sophisticated movements to treat soft tissues and joint structures. A physical therapist physically assesses and manipulates your joints, muscles, and tissues in order to diagnose injuries, reduce pain, and promote proper healing. Being skilled in these techniques sets physical therapists apart from other health care practitioners. There are many different types of manual physical therapy techniques, and your physical therapist will be able to determine which techniques best fit your needs.

Below is a clip of a Therapydia physical therapist demonstrating different manual therapy techniques that may be used during your treatment:

Manual Techniques for Your Condition

Manual physical therapy isn’t limited to a specific part of your body. Any joint, muscle, or tissue that is inflamed or tense may benefit from manual therapy. Manual physical therapy is helpful in treating a range of conditions from knee osteoarthritis, shoulder impingement, or even inflammation in the jaw.

Manual physical therapy effectively addresses the mechanical, biochemical, and psychological qualities of the treatment process. You can expect to see better range of motion in your joints and pain relief by improving how your brain processes pain signals. One of your body’s main systems that controls pain is activated by specific muscle movements, which means that implementing manual physical therapy in your treatments can help ease how much pain you experience.

Soft Tissue Techniques: Used when a muscle, tendon, or ligament is too tight and causing pain.

  • Soft Tissue Mobilization (STM)/Myofascial Release (MFR): Mobilization is a hands-on therapeutic technique that is designed to restore mechanical movement and increase range of motion by releasing tension within fascia. Fascia are sheets of fibrous tissue that surround and support muscles by separating them into layers. Following trauma or injury, fascia and muscles may shorten and restrict movement and blood flow. Depending on where your restrictions are located, your physical therapist will apply different directions of pressure to break down muscle adhesions.
  • Strain/Counterstrain: A physical therapist utilizing strain/counterstrain techniques will look for specific “tender points” in the body that indicates which fascial structure is involved. The technique is mainly used to reduce chronic and acute muscle spasms anywhere in the body. Once your physical therapist locates the fascial structure involved in the spasm, they position your body for a certain amount of time (i.e. 90 seconds to 5 minutes) so the muscle is shortened and relaxed. By subduing the spasm, major muscle groups are able to return to pain free functions.

Joint Techniques: Used to restore range of motion and flexibility for an injured joint.

  • Joint Mobilization: Physical therapists will use these manual mobilization techniques when joint structures are limiting the normal motion (i.e sliding, pivoting, etc.) of your joints. Using small and specific movements, a physical therapist manually moves a target synovial joint through natural levels of resistance. These motions stretch and strengthen the tissue surrounding the joint bone—normalizing joint motion, reducing spasms, and controlling pain.
  • Muscle Energy Techniques (METs): Muscle energy is an active technique used to reposition a dysfunctional joint and treat the surrounding muscles. It can be used to lengthen a shortened or spastic muscle or mobilize a joint that is stiff our restricted. The patient is guided through performing a specific muscle contraction against a resistive barrier, the physical therapist’s manual contact with the joint. Your physical therapist continues with this process until your muscle stretches further each time and range of motion improves.
  • Thrust Techniques, High Velocity/Low Amplitude (HVLA): This form of manual therapy applies a quick, shallow, and repetitive pressure to a particular joint. Your physical therapist manually finds joints that are moving abnormally. They then engage the barrier of motion in the joint with distinct rapid movements to restore natural motion. Therefore, the process allows for that particular joint to open and close properly and improve mobility and stability in the affected joint.

Do Manual Techniques Need A Physical Therapist?

Wh do these techniques need to be performed by an expert? Our physical therapists’ extensive knowledge of anatomy, joint mechanics, and muscle physiology makes them highly trained in manual treatment techniques. Each technique is specific to a certain type of injury and a specific part of your muscular system. For example, some specific techniques have hundreds of distinct movements that a manual therapy expert is trained for. Physical therapist’s have to consider how much pressure to apply, how quickly to move, where to apply therapy, and for how long to do so. In some cases, they have to direct your specific movements against their point of contact as well. You can expect manual therapy to reduce movement restrictions and help you move better.