When a physiotherapist manipulates a joint, it means we take the joint to its end of range and then we perform a quick thrust movement to which takes the joint past its normal range of movement. The reason behind passively manipulating joints is that it is an effective way to “free up” an acute locked joint (such as acute onset of a “wry neck”) or a joint that remains stiff even after treatment of joint passive mobilisation.
Whilst it is well researched and clinically shown to be a very effective treatment technique, joint manipulation does carry some risk if performed incorrectly therefore it is essential that only a qualified practitioner use this technique. Some physiotherapists have even completed a post graduate diploma in manipulation and they are known as manipulative physiotherapists.
Most joint manipulations are most commonly performed on the intervertebral joints of the spine and consist of thrust and rotation methods of manipulation. The patient has no control over these movements, instead you are asked to relax the area and not resist the movement the physiotherapist performs. Manipulating a joint often brings about immediate relief of stiffness.
Before manipulating a joint, a physiotherapist has to clear the patient with a subjective and physical examination of any contraindications to manipulation such as vertebral artery insufficiency, acute nerve or spinal cord compression, recent whiplash injury, rheumatoid arthritis of the first cervical (neck) joints as well as local malignancy, infection or fracture. We do not perform manipulation on children whose bones are still developing, on women in the last trimester of their pregnancy or on those who suffer from haemophilia.
Your physiotherapist will let you know if you are a suitable patient and if you will benefit from this excellent form of treatment.
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