Manual Therapy

Manual therapy is a specialized therapeutic modality where the practitioners apply pressure using their hands on your muscles and manipulate the joints to relieve the pain caused by various musculoskeletal conditions. Certain musculoskeletal conditions may result in restricted joint mobility which can cause discomfort, pain, changes in posture and movement. Manual physical therapy controls pain caused by muscle spasm, muscle tension and joint dysfunction thereby restoring normal range of motion.

Types of movements employed in manual therapy include:

• Soft tissue work: In this procedure pressure is applied to the soft tissues of our body. The pressure applied increases blood circulation, relaxes the muscles, breaks down the scar tissue and thus helps relieve the muscle pain. Special type of massages may also be performed based on the condition.
• Mobilization or manipulation: This involves use of measured movements of different speed, force and distances to align the bones and joints into position. It helps to relieve joint pain, improve joint flexibility and loosen tightened tissues around a joint.

Your physical therapist will perform a complete assessment of the blood and nerve supply, bones and muscles in the area to be treated after which one or the combination of the following manual therapy techniques may be recommended.

• Soft tissue mobilization: This procedure is performed commonly in the muscles surrounding the spine and involves rhythmic stretching and deep pressure. A traction force will be applied over the tight area of the muscle in order to reduce pain. It helps to break up the fibrous muscle tissue or myofascial adhesions such as scar tissue formed after back injury, move the tissue fluids and relax muscles.
• Strain-counterstrain: This technique is used to correct the abnormal neuromuscular reflexes that cause problems in posture. During the procedure, asymptomatic strain is induced by mild stretching when the patient is in comfortable position. This allows the body to reset its muscle tension to normal level.
• Joint Mobilization: Joint mobilization helps to set free the restricted joint and increase its range of motion by applying slow speed, increasing amplitude movements directly into the barrier of the joint, and moving the actual bone surfaces over one another such that patients cannot move the joint by their own.
• Muscle energy techniques: This technique restores restricted joint movements and lengthens short muscles. It is an active procedure and involves a voluntary contraction of patient’s muscles against a controlled counterforce which is applied by physical therapist. After a 3-5 second contraction, the joint is taken to a new barrier where a muscle contraction should be performed by the patient. This is repeated for 2 or more times.
• High velocity, low amplitude thrusting: This procedure restores the gliding movements of the joints. It involves thrusting the joint after taking it to its restrictive barrier.