Many patients, who have never been to a physiotherapist, usually think that physiotherapy is all about doing exercises with equipment. Or it’s all about the use of electrotherapy and thermotherapy packs as a treatment intervention. Although all these interventions are utilized during the treatment program, manual therapy is a technique that does not require any modality to impart treatment to the patients. Many patients experience more value with ‘hands-on’ and less value with ‘hands-off’ approaches. Manual therapy a ‘hands-on’ technique is proven to speed up the recovery period by increasing the patient's range of motion, strength, and endurance. In this blog, we will discuss manual therapy, its benefits, and the various techniques of manual therapy used by the physiotherapist during the treatment program.


What is Manual Therapy?

Manual therapy is a form of physiotherapy delivered with the hands. It has an important place in Physiotherapy when used appropriately. Hands are used to put pressure on muscles, tissues, and joints to decrease pain caused by muscle tension, spasm, and joint dysfunction.



·         Modulates pain

·         Reduces muscle tension

·         Increases relaxation

·         Decreases joint stiffness and ROM (range of motion)

·         Decreases inflammation

·         Improves tissue repair

·         Improves tissue stability and extensibility

·         Facilitates movement


Manual therapy techniques:

Manual therapy techniques can be helpful for the treatment of joints that lack mobility and ROM (range of motion). Manual Therapy is consists of a wide variety of techniques and some of them are:


Soft Tissue Mobilization

In this technique, the muscles are mobilized to break up the scar tissue. Mobilization also helps to remove the toxins from the damaged area thus increasing the speed of the healing process. Soft tissue mobilization helps to release the tension in the muscle causing an increase in flexibility and thus increasing the range of motion.



Massage is applied gently to the injured tissues to move the fluid which may assist in preventing adhesions. When massage is applied to the tendon it is kept taut and the muscle is usually kept in its shortened position when treating a muscle lesion, to separate the healing breach.


Scar Mobilization

A deep tissue massage breaks up the adhesions and the collagen fibers that are limiting the movement. Within the deep tissue, adhesions are broken down. The techniques used are friction massage, acupressure, trigger massage.


Myofascial Release (MRT)

Myofascial release technique (MRT), is applied by prolonged gentle pressure in specific directions, it may be used as an adjunct with any treatment prescribed to the patient. The treatment is given to treat the fascia which has become a tough connective tissue, under normal conditions it is like a gelatin substance.


Strain Counterstrain or (PRT)

Also known as positional release technique. It is a gentle technique used to relieve musculoskeletal pain and associated dysfunction, the treatment includes moving the patient's body passively away from the painful and restricted directions of motion.


Active Release Technique (ART)

Manual therapy is given to correct the soft tissue restrictions by breaking down the scar tissue and adhesions. The treatment helps to decrease pain, stiffness, and dysfunction. The patient is asked to actively move the affected muscle while the therapist maintains contact with the injured area, during the movement, the therapist can feel the structure as the therapist’s hands are in contact and thus effectively treating the restricted soft tissue structures.


Manual Lymph Drainage (MLD)

It is a gentle skin stretching massage technique that helps decrease various types of edema and also promotes the movement of lymphatic fluid out of the swollen limbs. The techniques used are static circles, scooping, pumping, and rotatory techniques.


Joint Mobilization

Passive traction techniques or gliding movements are applied to joint surfaces to maintain or restore the joint sliding, rolling, distraction, compression, and spinning, so that normal joint movement can occur as a person moves.


Joint Manipulation/Thrust/Mobilization

Passive skilled manual therapy techniques are applied to joints and soft tissues at varying speeds and amplitudes by using physiologic or accessory movements.


Muscle Energy Techniques

Muscle Energy Technique (MET) uses muscle's own energy in the form of gentle isometric contractions to relax the muscles. Types of contractions used in MET are isometric, isotonic, concentric, eccentric, and isolytic contractions.



The process of drawing or pulling. Traction is a manual technique is designed to reduce the pressure on the affected area, thus reducing pain.



A physiotherapist's extensive knowledge of anatomy, muscle physiology, and joint mechanics makes him highly trained in manual therapy treatment techniques. There is a specific technique for each type of injury and a specific part of the muscular system.  The physiotherapist is a trained professional who knows how much pressure is to be applied, where to be applied, how quickly to move, and for how long to do so.