Manual therapy treatments used by physiotherapists

Manual therapy treatments

Manual therapy treatments used by physiotherapists

Managing a chronic musculoskeletal condition or musculoskeletal pain requires a broad set of skills and treatments. Many of these treatments from your Lane Cove Physio provide a hands-on approach to help relieve your pain and stiffness and improve your mobility, movement and joint function.

What is manual therapy?

Manual therapy is the use of a variety of skilled hand movements to improve tissue extensibility, increase range of motion, induce relaxation, mobilise or manipulate soft tissue and joints, modulate pain, and reduce soft tissue swelling and inflammation.

Hands-on procedures such as mobilisation, manipulation, massage, stretching, and deep pressure are all components of manual therapy.

Is there evidence that manual therapy is effective in the treatment of spinal conditions?

Yes. There is an extensive body of evidence showing the effectiveness of manual therapy for cervical, thoracic, and lumbar spine conditions.

What is a physiologic and anatomic barrier?

A physiologic barrier is a point at which voluntary range of motion in a joint is limited by soft tissue tension. This is sometimes referred to as the end-feel of the joint. When the joint reaches the physiologic barrier, further motion toward the anatomic barrier can be induced.

Whereas an anatomic barrier is a point at which passive range of motion of a joint is limited by bone contour, soft tissues (especially ligaments), or both. The anatomic barrier serves as the final limit to motion in an articulation. Movement beyond the anatomic barrier causes tissue damage.

When is manual therapy treatment best used?

Manual therapy is used to treat a number of impairments that cause pain and decreased range of motion.

Motion impairment caused by weakened or shortened muscles is often an indication to use soft tissue techniques. Once pain has been reduced and joint mobility improved with the application of manual therapy, it is easier for a patient to regain normal movement patterns and restore maximal function.

Much of manual therapy is passive. However, some manual therapy techniques use the patient’s muscle contraction to assist or augment the treatment applied by the therapist.

What are the basic types of manipulations?

Manipulation consists of techniques using skilled passive movements to joints and/or soft tissues that are applied at varying speeds and amplitudes.

Thrust manipulation uses high-velocity, low-amplitude movement within or at the end range of motion of a joint, whereas non-thrust manipulation uses all of the same principles for soft tissue and joint impairments without the thrust component.

  • Joint manipulation (thrust)—a localised, single passive movement using a high-velocity, low amplitude thrust to bring the joint beyond its physiologic barrier. The result is distraction or translation of the joint surfaces. It does not exceed the anatomic barrier.
  • Joint mobilisation (nonthrust)—uses repetitive passive movements to return full range of motion and decrease pain. It moves joints within the physiologic ROM and uses three types of motion application: graded oscillation, progressive loading, and sustained loading.
  • Soft tissue mobilisation—aims at improving the status of muscle activity and/or extensibility in tissues. It may produce effects on muscular, nervous, lymph, and circulatory systems.

Current research has shown that manual therapy, when combined with physiotherapist led exercise, provides a beneficial outcome for patients. Therefore manual therapy is a common technique to be used in combination with exercise during your episode of care and return to full health.

What are the general contraindications to manual therapy?

While manual therapy is safe in most situations, your physio may avoid manual therapy on an area if you are suffering from:

  • Fracture
  • Instability of the target joint
  • Infectious arthritis
  • Tumors
  • Joint ankylosis
  • Acute inflammatory disorders
  • Presence of pathologic end-feel

I hope this sheds some light on what the broad term, manual therapy means in practice. If you’re interested in booking an appointment with us at Lane Cove Physio, give us a call on (02) 9428 5772 or book online at