PHYSIOTHERAPY: MANIPULATIVE PROCEDURES

This is the term covering a very wide range of techniques from the very gentle to the more vigorous, where an extreme range of movements is produced by the therapist.

Soft tissue techniques-The most familiar soft tissue technique is massage whereby muscles, tendons and ligaments are mobilised by the therapist’s hands and fingers in order to induce relaxation, increase local circulation and relieve pain and allow movement. Massage is usually used in conjunction with other procedures, for example ‘deep’ heat.

Regional mobilisation-For people with spinal problems, this is used to treat areas of stiffness and altered movement accompanied by pain. The techniques which are used often have an effect on groups of joints and their surrounding tissues. Regional mobilisation involves gentle and repeated passive movement of the affected area to relieve pain and increase the range of movement.

Localised mobilisation-When pain arises from a spinal disorder, the physiotherapist locates the level of the spine producing the symptoms, and may then use localised mobilisation techniques to relieve the pain and restore the normal range of movement. Localised mobilisations consist of passive, small-range, repetitive movements, usually in the painfree range.

The most vigorous of the manipulative procedures is the application of a deliberate thrust to increase joint mobility, taking the movement a little farther than it goes in ordinary active movements, but within the normal passive range. The manoeuvre should only be used by a therapist with special knowledge and skills.

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