Manual Therapy: restoring joint mobility

What is Manual Therapy?

Manual therapy involves skilled, controlled techniques to improve movement in stiff joints, relieve pain, and restore mobility. At Queens Physiotherapy, our expert team uses gentle, low-velocity manipulation methods as part of a comprehensive treatment plan, only when appropriate and with your informed consent.

Manipulation vs Mobilisation

it is important to understand the difference between manipulation and mobilisation:

• Mobilisation: A gentle, repetitive movement of a joint, often referred to as “articulation” in osteopathy. Mobilisation is widely used by physiotherapists and is highly effective for improving flexibility in stiff joints.
• Manipulation: This involves a quicker, more precise movement to encourage a joint to move more freely. it is sometimes described as “clicking” or “cracking,” though nothing is actually being “put back into place” or “realigned.” The sound that may occur comes from a process called cavitation, where gases within the joints fluid release due to pressure changes.

How Does Joint Cavitation Work?

To put it simply, think of a teacup on a saucer. If you spill a little tea, the liquid creates a suction effect between the saucer and the cup. Similarly, within a joint, synovial fluid creates a natural suction. When the joint is moved with precision and speed, it may release gases and produce a harmless “pop” sound.

At Queens Physiotherapy, we use low-velocity thrusts—a careful and controlled form of manipulation. Unlike the high-velocity thrusts (HVT) used in osteopathy or high-velocity low-amplitude techniques (HVLA) used in chiropractic care, our approach focuses on safety and comfort. This method requires advanced training but is often better tolerated and more comfortable for patients.

Is Manipulative Physiotherapy Safe?

Safety is our priority at Queens Physiotherapy. We do not perform manipulations on the upper cervical spine (above C4) to ensure a safe and effective treatment for all patients. You can feel confident knowing our physiotherapists use techniques that are gentle, carefully considered, and tailored to your needs.

As with all treatments, we require your informed consent before performing any manipulation. Your physiotherapist will explain the process, benefits, and any alternative treatments available, so you can make the best decision for your care.