Manipulation
Manipulation is a term used to describe treatments that involve “hands-on” techniques to improve movement. Manipulation and generally refers to treatments which are directed towards joints and therefore the candidate indication to use manipulation is that there is a particular problem in a joint or series of joints. Frequently this involves stiffness but at the other end of the scale can involve joints which have too much movement (hypermobility).
There are lots of different types of manipulation which are beyond the scope of this discussion but in general they can be divided into two categories:
- Thrust techniques (“clicking”)
- Mobilization techniques (always under voluntary control)
At physiotherapy we are specialist trained manipulative physiotherapist but the vast majority of hands-on treatment does not involve trusting techniques (clicking) as we feel there are other ways to achieve the same effect and some people don’t like the clicking sensation. It is important to recognize that there is a possibility of serious complications from inappropriate manipulation – particularly involving the cervical spine and this is one of the reasons why a high skill level is necessary to use these techniques and very specific patient selection is required.
It is also common to see people who initially got good symptom relief from manipulation (chiropractic, osteopathic or manipulative physiotherapy) but report less and less benefit as time goes by or in fact can be aggravated a consequence. In our opinion this is a clear indication not to pursue this type of treatment.
With mobilization treatments to technique involves a series of oscillating movements applied to an area and is always on pathology control of the patient and therefore can be stopped at any time if it becomes uncomfortable. The vast majority of our treatment at Dublin Physiotherapy involve joint mobilization techniques as a basis for treatment in combination with treatments that may be required for muscles, nerve tissue, posture, strength and coordination.
We are firm believers in hands-on therapies because most musculoskeletal problems involve a disturbance of body mechanics (biomechanics) and therefore require a mechanical solution to the problem not hot packs or electrotherapy machines.
