Manual Therapy 

Manual therapy is a specific form of therapy which delivered as a hands on treatment as opposed to by a machine or device. Pressure my be placed by the hands upon muscle tissue/tendons/ligaments and joints may be mobilized in order to decrease pain which is brought about by muscle spasm, muscle tension and joint dysfunction. There are many styles of manual therapy. 


Soft Tissue Mobilization (STM):

Following injury or immobilization soft tissue structures such as muscle, tendons and/or ligaments may be dysfunctional. The goals of soft tissue mobilization are to break down and/or reduce fibrous tissue which is more commonly know as scar tissue; decrease pain; increase range of motion and to decrease inflammation. All the effects of STM lead to the increase of the correct functioning of the soft tissue structures.  

 Myofascial Release:

Myofascial release is a form of soft tissue therapy that is used to treat painful muscles and restricted range of movement. The word myofascial refers to muscle and to the fascia that surrounds every muscle fiber. Pressure is applied by the thumb, elbow or other tools directly to the muscle in order to slowly stretch the restricted fascia and bring about  changes in the myofascial structures.  

Trigger Point Therapy:

Trigger points are tiny knot that may develop in a muscle when it is injured or overworked. Usually these areas can be quite sensitive and in some cases when a trigger point is active pain may be felt away from the site that is causing the problem eg. a trigger point on a muscle on your shoulder blade may refer pain down along the arm.  Treatment involves applying direct pressure to the trigger point until the taut band or knot is broken down. Dry Needling is also a highly effective treatment method.

Joint Mobilization:

Joint mobilization passive movement performed by the therapist on a joint in order  to relieve pain or restore motion. Joint mobilizations are classified in 5 grades which range from I - V. Grade I-II are small oscillatory motions are carried out on the joint that do not stretch the capsule that surrounds the joint or other soft tissue structures. Grade III-IV are larger oscillatory or sustained motions while grade V is the same a joint manipulation.  

 Mulligan Concept:

This is a form of treatment developed by Brian Mulligan in the 1970's. Mulligan proposed that injuries or sprains might result in a minor positional fault to a joint which in turn may lead to restrictions in physiological movement. Mobilizations with movement (MWMs) are performed on joints in the extremities to increase the quality of movement in the particular joint. For people who have restricted neck movements due to poor mobility in the cervical spine Natural Apophsyeal Glides (NAGs) may be carried out in order to increase the range of movement. These movements are basically gentle pain free glides that are performed on the restricted area. 

Other Mulligan techniques are Sustained Natural Apophyseal Glides (SNAGs) which mainly correct positional faults in a joint in the spine called the facet joint and Spinal Mobilizations with Limb Movement (SMWLM) which are techniques that can be used for restricted upper and lower limb movements that could be a result of a spinal dysfunction or abnormal neural dynamics.