Manual therapy is a clinical approach utilizing skilled, specific hands-on techniques, including but not limited to, massage, manipulation or mobilization. It should not be so painful that the patient reacts by tensing up.
Mobilization is a skilled passive movement of a skeletal joint including graded passive oscillations at the joint to improve joint mobility, e.g., movement of the coccyx.
Manipulation is a passive (for the patient) therapeutic movement, usually of small amplitude and high velocity, at the end of the available joint range.
Manipulation is a sudden small thrust that is controlled by the clinician.
Massage is the manipulation of the soft tissues of the body for the purpose of affecting the nervous, muscular, respiratory, and circulatory systems.
Therapist or self-directed massage of the abdominal wall with the aim of stimulating peristalsis and relieving the symptoms of constipation. Generally, the technique follows the ascending, transverse, and descending colon to aid emptying. The effect may be mechanical or sensory.
Skin rolling is a manual technique in which skin is pulled away from the underlying structures and elongated in various directions.
Scar massage is a specific application of soft-tissue mobilization to an adherent scar.
Thiele’s massage is a per rectal digital massage of the levator ani, sweeping length wise along the muscle fibers. Massage is begun lightly, and pressure is increased as tenderness decreases.
Myofascial Release Techniques
Myofascial release techniques consist of the use of deep friction and stroking of the fascia of the body to improve the ability of the fascia to deform and move within the body.
Myofascial Trigger Point Treatment
Soft-tissue mobilization specifically targeting trigger points and may include ischemic pressure, massage, myofascial release, shockwave, ultrasound, laser , dry needling (insertion of a solid needle into the TrP), and stretching.
A short or tense muscle is identified by examination and then released centrally along the bulk of the muscle or at the attachment to bone which is often more uncomfortable.
A trigger point will often refer pain elsewhere in the body or may just be painful on the spot. Once held for a few seconds the pain eases and the therapist moves on to the next point.There are also nerves and they can be mobilised along their pathways.