Manual Therapy

When most patients come in for their first appointment, they expect to receive ultrasound treatments, hot/cold packs, and a printed sheet of exercises to do, but this is not our approach to physical therapy. These modalities are used under many circumstances and are still incorporated into aspects of our practice; however, at PROCare Physical Therapy, we approach the restoration of function from a different perspective than most other physical therapy clinics. Our physical therapists are more interested in why a muscle or joint isn’t functioning properly and view exercise not as the driving mode of recovery but as a complement to manual therapy.

What is manual therapy and how can it help?

Manual therapy is a specialized form of physical therapy that takes a hands-on approach to physical therapy, instead of relying on a device or machine. During manual therapy treatments, our physical therapists use skilled hand movements to put pressure on muscle tissues and manipulate joints. This approach to physical therapy decreases pain, increases joint mobility and stretches dysfunctional tissues, returning normality to the body.

What kinds of manual therapy exist?

There are four notable forms of manual therapy used by our physical therapists: manipulation, mobilization, massage, and neuromuscular. Our physical therapists will decide which type of manual therapy is best suited for your condition upon their examination of your condition.  Each technique is used to treat a specific injury or certain muscle. Additionally, each technique has hundreds of movements and exercises that our physical therapists will guide you through to properly treat your condition. Our physical therapists are adequately trained and educated in how much pressure to apply and where, how quickly to move the patient’s muscles, and how long to do so.


Manipulation is the artful introduction of a rapid rotational, shear or force into a stiff joint. Manipulation is often associated with an audible popping sound caused by the instantaneous breakdown of gas bubbles that form during joint cavitation. Manipulation allows us to catch a muscle off guard.

Mobilization (Joint and Muscle)
A “restricted joint/muscle” often occurs after an injury such as falling, twisting, or straining a muscle. Injuring a joint can lead to muscle spasms and restricted movement. Joint mobilization movements of opposing bones such as a “glide and slide” helps get the joints working properly again. This technique is a more controlled process of articular and muscle (myofascial) stretching intended to improve bio-mechanical elasticity, ROM and flexibility.

Soft Tissue Massage (STM) or Myofascial Release (MFR)

STM or MFR is typically the repetitive rubbing, stripping or kneading of myofascial tissues to principally improve circulation and tissue mobility for increased healing. Its main focus is on muscles, ligaments and tendons. If a patient hasn’t had a chance to use a set of muscles due to illness, or has been injured in that area, the tissues can become scarred, and robbed of the precious fluids that promote flexibility and mobility. STM/MFR focuses on limbering up these damaged areas, while promoting overall wellness.

Neuromuscular Techniques

At times, muscles work themselves into abnormal states where the muscle and/or stretch reflex has difficulty relaxing itself. To treat this, our physical therapists use a technique known as “strain/counter strain” to guide the problematic muscle into positions that are “opposite” to the ones where the pain and tenderness start. Staying in this position of slight tension helps relieve the spasms by gently pulling the muscles into the opposite direction. There are other neurmuscular techniques that are also utilized to help treat certain conditions including, Active Release Technique (ART), Muscle Energy Technique (MET) and Feldenkris.

What are the benefits of manual therapy?

Manual therapy brings mobility back to stiff joints and eliminates muscle tension so that our patients can return to the activities that they love to do with no pain. This approach to physical therapy brings mobility, range of motion, pain relief, relaxation, flexibility, and circulation to the affected area. Scar tissue is broken up and muscles are loosened when manual therapy is properly used.

What instruments are used to promote healing?

Recently, new advancements in myofascial techniques have been introduced into the world of physical therapy. We began implementing these techniques right away due to their outstanding benefits and proven results. These techniques include the Graston Technique and Dry Needling . Implementing these techniques allow us to help treat and heal tissues quicker, thus, returning patient’s back to sports, recreational activities, and exercising. Our physical therapists are certified and trained to utilize the tools and filament needles needed to cox stubborn muscles and scar tissues into a state of relaxation.

Our physical therapists are highly qualified to practice manual therapy and the advanced techniques that come with it. With years of specialized training and experience, we provide gentle, hands-on therapies that address a broad range of muscle and joint conditions and injuries. Stop your pain today and call us to schedule an appointment.