Manual therapy is a term that relates to treatments given to soft tissue and joints where external manual forces are applied, usually by a therapist’s hands.
Mobilisation, manipulation of joints and massage are all examples of manual therapy. Soft tissue and joint mobilisations often involve pressure applied over a tissue or joint to address local pain or restriction. This pressure is graded from very light pressure too much more firm techniques depending on the problem or target tissues. Joint manipulation (also known as spinal manipulative therapy or spinal “adjustment”) is when therapists apply specific pressure (known as controlled thrust “a targeted joint movement at high force performed by a physiotherapist with additional training”) to a joint.
Joint manual therapy such as mobilisations or manipulations are shown to reduce pain and can occasionally be associated with a “popping sound”, which is caused by natural pressure changes in the joint. It is important to recognise that this treatment technique (and its sound) isn’t linked to a joint being out of position. Unfortunately, there are still some misconceptions that joints can be “out of place” which is not supported by research evidence and creates unnecessary fear.
Manual therapy involves utilising specific hands-on techniques including manipulation and mobilisation. It is used to treat soft tissues and joint structures to increase range of motion whilst reducing pain.
We are trained to deliver manual therapy and it is often used in conjunction with exercise to assist with stiff and painful areas to get you back to full function.
This will include an assessment of your range of movement as well as putting hands on the affected area to ascertain areas of discomfort to ensure the treatment is most effective.
What Is It?
Joint manipulation (also known as spinal manipulative therapy or spinal “adjustment”) is when our physios apply specific pressure (known as controlled thrust “a targeted joint movement at high force performed by a physiotherapist with additional training”) to a joint.
Joint manipulation is shown to reduce pain and can be associated with a “popping sound”; this is caused by natural pressure changes in the joint. It is important to recognise that this treatment technique (and its sound) isn’t linked to a joint being out of position. Unfortunately, there are still some misconceptions that joints can be “out of place” which is not supported by research evidence and creates unnecessary fear.
Current Research
For chronic low back pain, spinal manipulative therapy, delivered as part of a wider treatment package, has demonstrated to be similarly effective as other effective treatment options for eliciting short-term reduction in pain and can produce better short term improvements in function (8). This is supported by research which recommends spinal manipulative therapy alongside other soft tissue techniques, exercise prescription, advice and education and usual medical care (1). Additionally, moderate-quality evidence states that spinal manipulation and mobilisation can improve function and reduce pain in chronic low back pain (3).
What Is It?
Joint mobilisation is where our physios apply pressure of different levels of intensity to a specific joint to assist with stiffness and pain.
Joint mobilisation is often used in spinal and peripheral joints (shoulders, knees, ankles, etc) and can provide good outcomes, especially when used as part of a wider treatment approach.
Current Research
Joint mobilisation involves applying pressure to help the joints move more freely; this can reduce spinal stiffness and pain in patients with low back issues (9) and can reduce pain at rest and with the most aggravating movement (10).
Following an ankle sprain, joint mobilisations have shown to induce a short-term improvement in dynamic balance and dorsiflexion (bending the ankle) which can be a useful addition to a broad spectrum treatment approach (12). Joint mobilisation techniques can also reduce pain levels in patients with knee osteoarthritis (4) and lower pain levels in those with thumb osteoathritis (11). For frozen shoulder, manual therapy combined with a home exercise programme can improve range of motion and function (2).
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