Manual therapy techniques are described as “skilled hand movements and skillful passive movements of joints and soft tissue,” by the American Physical Therapy Association (APTA). To put it another way, it’s a physical treatment that relies on the hands of the practitioner rather than equipment.

The Different Types of Manual Therapy Techniques

Various types of manual therapy techniques are used to treat conditions causing pain. Before initiating any form of treatment, it is standard practice for the practitioner to conduct a full evaluation of the individual’s condition to assess the type of manual therapy technique to be employed as well as to ensure if it is an appropriate form of treatment. An examination of the muscle and bone in the concerned area along with an assessment of nerve and blood supply is conducted. This helps assess whether the pain management technique will be effective and beneficial or if it will induce adverse effects. Following the assessment, the practitioner may implement either one or a combination of manual therapy techniques to relieve their patients of discomfort.

physiotherapist hard massaging relaxed patient neck

Soft Tissue Massage

Understanding the function of muscles and where they link to joints is crucial. Once joint motion is restored, muscle tension frequently decreases, but the spasm frequently persists. If muscle tension is present, the dysfunction of the joints may reappear. The purpose of soft tissue mobilization (STM) is to loosen up tight, inflexible muscle tissue (also known as “myofascial adhesions”), such as scar tissue from a back injury. STM involves deep pressure and rhythmic stretching of the muscles surrounding the spine, it is frequently used to treat such conditions. Through layer-by-layer analysis, the therapist will pinpoint the precise location of the most severe tissue constriction. ​​These limitations can be handled using a broad range of approaches once they have been identified. These methods frequently entail applying a traction force to the constricted area in an effort to return the tissue’s typical texture and lessen the pain it causes.

Joint Manipulation

Joint manipulation is another manual therapy technique used by practitioners to treat patients that suffer from joint pain or frozen joints. It entails giving the joint a brief, light shove in order to reduce pain and increase mobility. It frequently, but not always, comes with a click or pop sound that can be heard. First, the physiotherapist will conduct a comprehensive examination of the damaged area and a complete review of the concerned’s medical history. Joint manipulation is not recommended for patients with osteoporosis, broken or weak bones, neurological deficiencies, bleeding diseases, excessive joint mobility, and extreme pain. They are likely to be denied this form of therapy.

Following the screening examination, the therapist will arrange the individual in the appropriate position depending on which joint is to be manipulated. The physical therapist will identify the appropriate area or joint to manipulate based on the symptoms. They will then apply a small and rapid force to the joint, generating cavitation that will result in one or more audible “pop” sounds. These manipulations can be carried out on joints other than those of the spine as well as at different levels of the spine. This includes the lumbar (lower back), thoracic (mid back), or cervical (neck) regions of the back and neck. Joint manipulation has also come to be known as high-velocity; low-amplitude thrust manipulation.

Joint Mobilisation

Joints can oftentimes become dysfunctional due to overuse, trauma or even neglect. Similar to joint manipulation, physiotherapists utilise a method called joint mobilisation to restore the small and involuntary movements that enable joints to function at their optimal capacity. Joint mobilisation involves oscillating the joint back and forth in an attempt to recover effective motion.

The practitioner checks the joint function and measures the pain level that may limit the joint’s range of motion. Then, the optimal oscillation grade to activate mechanoreceptors (sensory nerve endings that respond to external stimuli) is selected. The thrust’s force rises with each grade, with Grade 1 just activating skin receptors while Grade 5, the highest, is delivered when the joint is almost at its maximum range (the furthest the joint can go). This has the dual benefits of temporarily increasing passive motion and decreasing discomfort.

physiotherapist applying pressure to patient joints

Friction Massage

A massage technique called friction massage is used to improve circulation and loosen up tight areas, particularly those near joints and those with adhesions in the muscles or tendons. “A precisely delivered penetrating pressure applied through fingertips” is how friction massage is defined. According to the founder of friction therapy, deep tractions are effective for treating tendinopathy, ligament lesions, scar healing, and muscular strains. The therapist’s job is to promote fibroblast proliferation in the scar, reduce scarring that forms perpendicular to the actin and myosin filaments, and create a robust, mobile scar that won’t cause repetitive pain when returning to daily activities.

Friction massage attempts to alter the behaviour of cells in all soft tissues. Key features of friction massage include the identification of the concerned tissue by employing diagnostic motions and palpation techniques. To prevent skin damage, the physical therapist’s fingertips and the patient’s skin must move in unison. To minimise the appearance of the scar, the massage must be applied perpendicular to the tissue’s fibres. The massage must be performed with enough sweep to ensure that the entire scar is addressed. Deep friction must be applied while staying within the patient’s pain threshold. The massage will gradually relieve the ache. In order to adequately expose the tendon, the patient must adopt a certain stance. The muscle must be stretched out if the lesion is located in the muscle belly. This will help the muscle fibres separate throughout the massage. The sheathed tendon must be stretched to ensure that the massage is as effective as possible.

Passive Stretching

Stretching is a crucial component of exercise. Its advantages improve muscle function, enabling you to move more comfortably and easily throughout your daily and athletic activity. An individual may stretch passively by remaining still for a predetermined period of time. The body can unwind while a partner, accessory, or prop applies pressure to the body to further the stretch. A wall or the ground may also be utilised. Regular stretching improves flexibility, increases range of motion, and lowers the risk of injury. Less muscle strain, pain, and tightness, which are common after exercise, will make the body feel better. Flexibility, range of motion, and mobility can all be improved with passive stretching. It lessens the chance of injury while enhancing performance. People who might be unable to stretch on their own can still benefit from it.

Additionally, passive stretching may promote muscular growth and protect muscles against weakening. Passive stretching for a little duration each day can help increase muscle strength. Research suggests that passive stretching may be advantageous for those who are unconscious or paralysed, while more investigation is required to confirm the long-term benefits. Moreover, performing regular stretches enhances blood flow to the muscles, which may enhance their functionality. Splint-assisted muscle stretching is particularly beneficial for elderly or disabled individuals who are unable to exercise on their own. Passive stretching with a partner or practitioner may enhance the stretch’s motion or range. Incorporating some form of passive stretching into your daily routine is recommended for every individual, undergoing treatment or not.


Trigger Pointer Therapy

In addition, Trigger Point Therapy involves applying pressure to uncomfortable, sensitive places to ease the pain in the affected area and other parts of the body. Trigger point therapy may occasionally be combined with a massage to alleviate pain. It is a form of neuromuscular therapy. Like other forms of therapy, it is intended to ease pain, with the additional benefits of correcting muscular imbalances and hastening the healing process following an accident. The physiotherapist will first stretch the muscle before applying pressure to any knots or regions of tightness. This facilitates healing and relieves muscle strain.

Following muscle trauma, the muscle becomes inflamed. This is the body’s way of protecting the muscle from additional injury. The concept of this form of therapy is to “reprogram” the neuromuscular system using trigger point mechanisms. This influences the muscles to return to their non-inflamed condition. As the inflammation is mitigated, the patient feels less pain and tightness, which helps the body repair.

physiotherapist conducting shockwave therapy

The Benefits of Manual Therapy Techniques

This form of treatment is focused on expert “hands-on” therapy. Manual therapy aims to reduce pain and increase the mobility of joints, soft tissues, and nerves. Physiotherapists and osteopaths at Heartland Rehab have honed their manual treatment abilities both during their undergraduate studies and additional postgraduate training. Furthermore, this treatment form may be considered more “natural” with little to no reliance on medication that induces side effects. A range of illnesses and disorders are assessed, diagnosed, and treated with manual therapy. In order to speed up the return of function, physiotherapists typically mix manual treatment with exercise prescription and rehabilitation.

Some benefits of manual therapy are as follows:

  • Increases the range of motion as well as joint mobility
  • Enhance tissue repair
  • Regulates pain
  • Increase tissue extensibility and stability
  • Decrease inflammation in delicate and soft tissues
  • Encourage relaxation
  • Decrease muscle tension
  • Facilitates therapeutic exercise and movement

Is Manual Therapy the same as Massages?

Manual treatment can be confused with a massage since it depends on the practitioner’s skill set and requires specific hand movements. These two therapy modalities do, however, have important distinctions. A massage involves applying pressure to the skin and soft tissues of the body in a rhythmic manner. Massage helps to improve circulation, relaxation, and flexibility while easing tension, anxiety, and stress. On the other hand, the use of hands-on techniques on bodily tissues with the goal of therapeutic assessment and treatment is known as manual therapy. A physical therapist can use manual treatment techniques to improve the healing process and fix positioning concerns with inflamed tissues by accurately examining the relevant bodily components.

Soft tissue mobilisation, myofascial release, strain-counter strain, muscle energy techniques, joint mobilizations and manipulations, and mobilisation with movement, as well as other techniques mentioned above, are some manual therapy procedures used by physical therapists. Manual therapy can be used to evaluate dysfunction, extend joint mobility, lessen discomfort, and enhance recovery. Both manual therapy and massage can be used as a component of a strategy to advance a person’s general health and fitness. However, manual therapy requires a considerably more extensive level of training and expertise. Physical therapists are highly educated medical professionals who get in-depth training in the application of manual therapy techniques for both patient assessment and treatment. The two could even be used simultaneously to elicit the desired result. Therapists at Heartland Rehab work with patients using manual therapy to help them achieve the outcomes they require to return to their everyday activities while lowering their discomfort.

The Difference between Physiotherapy Treatments and Manual Therapy Treatments

Terms like manual and physical therapy can be difficult to discern. The names are frequently used interchangeably in normal day settings. However, physical therapists use them quite specifically. So what distinguishes manual treatment from physical therapy? Do you recall studying sets and subsets in math class? Well, manual therapy is a branch of physical therapy. Therefore, even while all manual treatment falls under the category of physical therapy, not all types of physical therapy fall under the umbrella of manual therapy.

The word “manual” can signify many things, including “physical.” Is it surprising that people are perplexed? “Using the hands” or “hands-on” is the appropriate definition of manual therapy for us. Manual therapy is literally hands-on therapy for physical therapists. Physical therapists treat patients with their hands. Additional therapies that could be referred to as “hands-off” are included in physical therapy. In order to rehabilitate their bodies, physical therapists frequently help patients use exercise equipment. Physical therapists don’t differentiate between manual and physical therapy because one approach is superior to the other. Only in very rare circumstances or cases might one type of therapy offer a more suitable and efficient course of treatment.

The ability to pinpoint the cause of a patient’s condition is a key difference between manual and physical treatment. Physical therapists who have received training in manual treatment methods can isolate the precise joint or tissue that is causing the patient’s problems with their hands. No other assessment instrument can match the information the hands convey.

To conclude, various forms of treatment are used to alleviate pain and/or discomfort. It is important to conduct proper research before undergoing any form of therapy. Should you have any more enquiries, please feel free to contact us immediately.


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