Mobilization & Manipulation

Physiotherapists are experts in treating problems that affect the bones, joints, muscles and connective tissues of the body. These may include congenital orthopaedic conditions, clubfoot, fractures, torticollis, septic arthritis, brachial plexus injuries, Bells Palsy, and scoliosis. An assessment determines the areas of weakness and pain; posture analysis is performed. Exercise, mobilization, stretching, myofascial release, and strengthening are all performed to correct alignment and posture, decrease pain and improve mobility.
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What is Orthopaedic Manipulative Therapy?

"Hands-on" treatment provided by the physiotherapist. Treatment could include; Moving joints in specific directions and at different speeds to regain movement. Muscle stretching. Passive movements of the affected body part. Moving the patient's body part against the therapist's resistance to enhance muscle activation and timing. Specific soft tissue techniques can also be used to improve the mobility and function of tissue and muscles.
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Skilled hand movements intended to achieve any or all of the following results:

• improved tissue extensibility

• increased range of motion of the joint complex

• mobilize or manipulate soft tissue and joints

• induce relaxation

• change muscle function to modulate pain and reduce soft tissue swelling

• inflammation movement restriction

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Techniques we often use:

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Manipulation:
Passive, high velocity, low amplitude thrusts applied to a joint complex within its anatomical limit with the intent to restore optimal motion, function or to reduce pain.
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Mobilization:
Manual therapy techniques comprising of a continuum of skilled passive movements to the joint complex that is applied at varying speeds and amplitude/high-velocity therapeutic movement (manipulation) with the intent to restore optimal motion, function or reduce pain.
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Myofascial and Joint Mobilisation:
Fascia surrounds muscles, bones, and nerves. It separates, connects, supports and protects these structures. Fascia may become restricted resulting in decreased flexibility. Myofascial and joint mobilisation is the application of sustained pressure and movement to eliminate fascial restrictions and restore motion and alignment.
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ESWT (Extracorporeal Shockwave Therapy):
A non-surgical procedure used to cure chronic plantar fasciitis, Achilles tendonitis, tennis elbow, shoulder tendonitis, and other chronic tendinopathies.
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ESWT benefits patients due to the ability to treat the condition extracorporeally (meaning outside of the body). Since ESWT is non-invasive, there is no lengthy recovery period with virtually no downtime or risk of causing further damage.
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Dry Needling:
Trigger-point dry needling is an invasive procedure that incorporates acupuncture needles that are inserted into the skin and muscle. Focused on myofascial trigger points which are hyperirritable spots in skeletal muscle. These trigger points are associated with a hypersensitive palpable nodule in a taut band. Dry needling can be carried out at a superficial or deep tissue level.
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Friction Massage:
Increases mobilization of adhesions between fascial layers, muscles, compartments and other soft tissues. Friction Massage creates an inflammatory response and focusses on injured areas.
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Stretching:
A form of physical exercise where a specific muscle or tendon (or muscle group) is deliberately flexed or stretched to improve the muscle elasticity to reach a comfortable muscle tone, resulting in muscle control, flexibility, and range of motion.
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Kinesio Tape:
Kinesiotaping is used to help facilitate or inhibit muscle function, support joint structure, reduce pain and provide proprioceptive feedback to help achieve optimal body alignment.
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Home Exercise Programmes (HEP):
A series of exercises that patients execute at home to maintain strength and increase therapeutic reward. Home exercises are devised to be practical, accessible and feasible so that patients can maximize efforts without instruction. A home exercise programme encourages patients to participate in specific movements, to continue a patient's recovery progress outside of the physiotherapy office. Patients could increase their chances for recovery by regularly performing these exercises and strengthening musculature.
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Prescription and Fitting Of Assistive Devices:
Assistive devices help maintain proper alignment of the body and help prevent the development of deformities. A physiotherapist will work with occupational therapists and Orthotists to prescribe and fit various assistive devices such as wheelchairs, crutches, and AFOs to name a few.  A complete orthotic prescription should include the following; The patient's diagnosis, the type of footwear to use, and include the joints it encompasses and specifies the desired biomechanical alignment, as well as the materials for fabrication.
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