Manual Therapy Techniques

What Are the Most Common Manual Therapy Techniques?


Hands-on, manipulative therapies have been used worldwide to treat and heal the body for centuries. The earliest known reference to manual therapy dates back to Europe in 400 BCE. Today, physical therapists utilize manual therapy to address neuromusculoskeletal pain and joint dysfunction without surgery and without medication. Read more about hands-on manual therapy techniques for many common injuries and health conditions.

What Is Manual Therapy?

Manual therapy is an advanced form of physical therapy that consists of specific, hands-on examination and treatment techniques commonly used in combination with other therapies and education to address pain and function loss.

The physical therapist uses their hands to apply pressure on joints and soft tissues such as muscles and ligaments to reduce pain and dysfunction. Pain reduction is one primary goal of manual therapy, but these techniques offer several other benefits. Skilled hands-on movements of joints and soft tissues are used to:

  • Control pain
  • Facilitate tissue repair
  • Improve range of motion
  • Increase tissue extensibility
  • Manipulate/mobilize soft tissues and joints
  • Reduce restriction, swelling, and inflammation

And what’s one more amazing side effect of manual therapy? Many patients find it incredibly relaxing too!

What Are Manual Therapy Techniques for Pain Relief?

Now we’ll dig a bit deeper and explain common manual therapy techniques for pain and other musculoskeletal symptoms and injuries.

Soft-Tissue Mobilization

Soft-tissue mobilization (STM) combines pressure and stretching to relax rigid muscles, release tension, and move fluids causing pain and inflammation. Manual therapy soft-tissue mobilization techniques include:

  • Myofascial soft tissue mobilization: localized, gentle techniques include stroking, kneading, compression, and vibration to reduce pain and increase muscle length
  • Instrument-assisted soft tissue mobilization: the application of stainless steel tools to gently improve mobility, blood flow and scar tissue
  • Strain-counterstrain: gentle, passive technique corrects postural and structural issues linked to tight muscles, joints, and tissues
  • Trigger point therapy: also called myofascial release, this involves deep tissue massage to treat chronic muscle pain and immobility
  • Cross friction: localized, deep tissue massage used to improve mobility, prevent scar tissue from forming, and promote healing

Joint Mobilization

As the name suggests, joint mobilization technique loosens restricted joints to improve mechanics and range of motion. During joint mobilization, the therapist applies graded force to the affected joint in specific directions to increase mobility in that joint.


With a joint manipulation or quick stretch to the joint, you might hear a “pop.” This is normal and the presence or absence of this sound doesn’t change the positive benefits of the technique. It is ideal for patients with shoulder, back, ankle, and knee joint pain and/or stiffness,

Active-Release Therapy for Adhesions

After a soft tissue injury, surgery, or infection, the body attempts to heal itself through the inflammation process. Adhesions are formed in the process. Adhesions are thick, fibrous bands of scar tissue that stick to two body surfaces which are not usually connected. Some painless adhesions do not require treatment.


Others cause pain with movement and are even thought to potentially impact organ function. Physical therapists can break up adhesions with active-release therapy, applying  deep tenderness at the site, as the patient moves the injured site to an extended position. This allows the soft tissue to move a bit further, increasing flexibility and range of motion. As adhesions breakdown, patients find they can move better and have less pain.


These are a few of the numerous techniques physical therapists use in conjunction with other manual therapies that are beneficial for a wide array of conditions. to help patients feel and move better. Effects are even greater when combined with exercise, education, and home exercise adherence.

Who Can Benefit From Manual Therapy?

Manual therapy is often part of an integrated approach to treating a wide range of conditions, including:


Physical therapy is highly-individualized for each patient, and every treatment plan is unique. A comprehensive evaluation is the first step in that process. Do you want to learn more about manual therapy and find out if it’s right for you? Find a physical therapy clinic near you.

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