The use of manual therapy techniques to improve range of motion and decrease pain

The use of manual therapy techniques to improve range of motion and decrease pain

Manual Therapy is a type of physical therapy that is administered using the hands. It is a technique used by physiotherapists to assess and treat patients using skilled hand movements. 

The overarching goal is to increase tissue extensibility, range of motion, induce relaxation, mobilize or manipulate soft tissue and joints, modulate pain, change muscle function, improve movement patterns, and reduce soft tissue swelling, inflammation, or restriction. 

The Advantages of Manual Therapy 

Manual therapy has numerous advantages, including pain relief, stress reduction, increased joint mobility and soft tissue health, increased blood flow, and reduced inflammation. Along with appropriate exercise progression, incorporating manual therapy into your treatment plan is an excellent way to ensure that you get back to doing what you love as soon as possible. When your joints and tissues become dysfunctional, manual therapy can be a great way to start restoring normal movement patterns. 

As an example, consider headaches. Your therapist may identify areas of joint and tissue stiffness as well as associated areas of weakness during your evaluation. Based on their findings, the therapist would use manual techniques to restore movement and reduce pain in your spine. Your therapist would also use manual exercise progressions to promote strength and stability in weak areas. Your therapist can give you stretches to do all day, but when combined with manual techniques, you should have a faster response time and fewer headaches. 

Manual Therapy is a broad umbrella term that encompasses a variety of specific hand-on techniques, some of which are as follows: 

Techniques For Soft Tissue: 

Mobilization of Soft Tissues 

Soft tissue mobilization works by moving muscles, which breaks up scar tissue. The mobilization also aids in the removal of waste products from the damaged area, which speeds up the healing process. Soft tissue mobilization aids in the release of muscle tension, increasing range of motion and flexibility. The therapist employs various techniques such as sustained pressure, direct oscillations, perpendicular mobilization, and parallel mobilization. 


Massage helps to move fluid and, when applied carefully and gently to injured tissue, may help to prevent adhesions. Tendinous lesions are treated with a gentle transverse dose applied to the fibres to smooth roughened surfaces or to keep the tendon mobile within its sheath. When used, the tendon is kept taut, and when treating a muscle lesion, the muscle is usually kept shortened to avoid separating the healing breach. 

Read More: Physiotherapist vs Chiropractor: How Do They Differ? – About Pakistan

Mobilization of Scars 

A deep tissue massage loosens the adhesions and collagen fibres that are impeding your movement. Deep tissue is where adhesions are broken down. Friction massage, acupressure, and trigger pointing are among the massage techniques used. 

Myofascial Release Therapy ( MRT) 

Myofascial release, a hands-on technique that applies prolonged light pressure with specific directions into the fascia system, can be used as an adjunct to almost any treatment that the patient is receiving. The fascia is a tough connective tissue with an elastic component, a collagenous or plastic component, and a matrix or ground substance that is a gelatin-like substance under normal conditions. Within the fascia, cross restriction can occur for a variety of reasons. 

Strain vs. Counter strain (PRT) 

Positional release technique is another name for it. It is a gentle technique used to treat musculoskeletal pain and dysfunction. Its treatment action moves the patient’s body passively away from painful and restricted directions of motion. 

Technique of Active Release (ART) 

Manual therapy aims to correct soft tissue restrictions by breaking down scar tissue and adhesions, reducing pain, stiffness, muscle stiffness, and dysfunction. While the therapist presses or maintains contact on the injured area, the patient actively moves the affected structure, muscle, or ligament. This allows the therapist to feel the structure as it moves under their contact, allowing them to treat those restricted soft tissue structures effectively. 

Lymphatic Drainage by Hand (MLD) 

It is a gentle skin stretching massage technique that aids in the movement of lymphatic fluid out of swollen limbs as well as the reduction of various types of oedema. Stationary circles, scoop technique, pump technique, and rotatory technique are used. 

Joint Techniques: 

Mobilization in Joints 

Passive traction or gliding movements applied to joint surfaces to maintain or restore normal joint play (distraction, sliding, compression, rolling, and spinning) so that normal roll-slide joint mechanics can occur as a person moves. 

Manipulation/Thrust/Mobilization in Joints 

For therapeutic purposes, passive skilled manual therapy techniques are applied to joints and related soft tissues at varying speeds and amplitudes using physiologic or accessory motions. 

Muscle Energy Technique  

Muscle Energy Technique (MET) is a type of manual therapy that uses the muscle’s own energy in the form of gentle isometric contractions to relax and lengthen the muscles via autogenic or reciprocal inhibition. Isometric contraction- hypertonic shortened muscle, isotonic contraction- inhibited weakened muscle, concentric contraction- mobilize joint against its motion barriers, eccentric contraction- isolytic contraction- fibrosed muscles are the types of contractions used in MET. 


The act of drawing or pulling something. Traction is a manual technique used to relieve pain by reducing pressure on the affected area. 

Manual therapy can be used to treat a wide range of injuries and problems. Among them are: 

Neck pain can be caused by disc pathology, muscle spasms, post-surgical neck pain, or rib hypo mobility. 

Disc Pathology, Post-Surgical Back Pain, Spinal Stenosis are all causes of lower back pain. 

Thoracic Spine versus Mid-Back Spine 

Migraines and headaches 

Hip pain can be caused by hip impingement, myofascial hip pain, hip bursitis, or post-surgical hip replacements. 

Knee Pain: Total Knee Replacements, IT Band Tendonitis. 

Ankle Sprains, Chronic Ankle Pain, Ankle Arthritis, and Post-Surgical Ankle Pain are all examples of ankle pain. 

Frozen Shoulder, Impingement Syndrome, Post-Surgical Shoulder, Rotator Cuff Syndrome are all causes of shoulder pain. 

Trigger points in the muscles. 

Ankle pain can be caused by an ankle sprain or by fused joints. 

Wrist pathologies cause wrist pain. 

Tennis elbow and golfers elbow are two types of elbow pain. 

Dysfunction of the temporomandibular joint 


Types of arthritis. 

Read More: How physiotherapy is effective for health? – About Pakistan

Is Manual Therapy Appropriate For Me? 

While manual therapy is an important component of many physical therapy treatments, it is not appropriate for every patient. Medical conditions requiring improved stability, such as joint hypermobility, may require a treatment that does not involve manual therapy. Because of lower bone density and the inherent risk of fracture, other conditions, such as osteoporosis, may not benefit from manual therapy. Before using manual techniques, your therapist should be aware of a variety of other conditions. 

Techniques are always used with the goal of alleviating pain and improving function. Treatment options include everything from gentle soft tissue mobilization/massage to increased pressure on specific joint structures to improve range of motion. 

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