What Is Manipulative Physiotherapy?

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  • Written By: Marlene de Wilde
  • Edited By: O. Wallace
  • Last Modified Date: 22 February 2020
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Manipulative physiotherapy is a branch of physiotherapy which refers to the hands-on treatment of joint and muscle problems. Therapists specializing in this type of physiotherapy are highly skilled in assessing, diagnosing and using manipulative techniques to manage musculoskeletal conditions. The conditions treated by manipulative physiotherapy include musculoskeletal, sports and occupational injuries which are treated by manipulating the soft tissue and mobilizing the joints in the limbs as well the back.

While all physiotherapists are familiar with manipulative techniques, a manipulative physiotherapist has undergone further training and may even take advanced university courses. These courses may be referred to as Manipulative Physiotherapy or, as is becoming more common, Musculoskeletal Physiotherapy in recognition of the fact that not every condition will require physical manipulation. The goals of manipulative physiotherapy include pain reduction, injury management and recovery and an improvement in flexibility, strength and co-ordination.

A manipulative physiotherapist is highly trained in the assessment of musculoskeletal disorders which is based on clinical reasoning, scientific evidence and by using the hands to diagnose restrictions in movement. This enables the management of the condition diagnosed in the most accurate and cost-effective way. Evidence has shown that the techniques used in manipulative physiotherapy such as spinal manipulation therapy (SMT) together with evaluation techniques like the McKenzie Method® and the promotion of activity early in the treatment process are more effective than treatments such as massage, bed rest and the use of pain relievers such as analgesics.


There are three approaches to spinal manipulation. Osteopathy aims to increase mobility through restoration of full movement to the spinal joints. Chiropractic concentrates on shifting dislocated vertebra back into place and manipulative physiotherapy focuses on loosening joints and stretching muscles. Tissue injury through a single event such as the clumsy lifting of an object or through repetitive stress over time may result in restricting the movement of the joints which causes pain and disability. The aim of manipulating the joints through controlled movements is to relieve muscle tightness, restore mobility and thus reduce pain and discomfort.

Physiotherapy is not only used in the treatment of musculoskeletal injuries, but is also used in the treatment of neurological conditions such as stroke, in conditions such as multiple sclerosis and cardiothoracic conditions such as asthma. In addition to manual therapies such as manipulative physiotherapy, exercise programs and electrotherapy techniques are also used, depending on the treatment plan. Electrotherapy techniques include the use of ultrasound, laser therapy and electrical nerve stimulation.


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