Manual Therapy Kitchener, Waterloo & Elmira, ON

Manual Therapy

For many physiotherapists, it’s all hands on deck. They use manual therapy techniques on soft tissue and joints that are intended to modulate pain, reduce inflammation, increase range of motion and reduce restriction. The hands-on therapy is also intended to decrease edema, enhance health, remediate body functions and structures and to maintain physical performance. But, before performing any type of hands-on treatment, a physiotherapist will perform a full assessment of bone and muscle and blood and nerve supply in the affected area. Depending on that assessment, a physiotherapist may perform some or a combination of the following types of manual physiotherapy. You can feel confident that a physiotherapist will choose the best manual therapy for your condition.

Joint Mobilization

Usually, if you have a pulled muscle in the neck or back, you’re instructed to treat it with heat or ice. While these treatments may provide temporary relief, the pain soon returns. With joint mobilization, the restricted joints are loosened up through manual therapy by providing amplitude and slow velocity to the affected joint. The joint is moved in a manner that the patient cannot do on their own.


This type of manual treatment focuses on fixing abnormal neuromuscular reflexes that are causing painful tender points. The physiotherapist locates the patient’s position of comfort, holds it for 90 seconds and asymptomatic strain is induced by stretching. It’s a gentle technique for those with acute back problems and tolerated well by patients. Get rid of back pain with strain-counterstrain therapy.

Soft Tissue Mobilization

Muscles play an important role around the joints. If there is too much tension, there can be muscle spasm and joint dysfunction. With soft tissue mobilization, the fibrous muscle tissue is broken up. Typically, this is scar tissue or adhesions. This procedure is often applied to the musculature surrounding the spine and consists of deep pressure and rhythmic stretching. A layer-by-layer assessment is done by the physiotherapist to localize the affected area. Soft tissue mobilization can also involve placing a traction force on the affected area. All around, soft tissue mobilization has helped reduce pain and remove restricted movement in many patients.

High Velocity, Low Amplitude Thrusting

This manual therapy technique is a bit more aggressive than others. Its goal is to allow the joints to open and close more effectively to restore motion. The joint is taken to its restrictive barriers and thrusted. However, it does not move the joint past its anatomical limit, so there is no pain or structural damage. This technique specifically increases range of motion. With high velocity, low amplitude thrusting, you can finally move again.

Muscle Energy Techniques

Muscle energy techniques are implemented by a physiotherapist to lengthen shortened muscles and to mobilize restricted joints. A voluntary contraction is utilized against a controlled counterforce applied from the physiotherapist from a specific direction and position. It’s an active procedure and generally well tolerated by patients.

In addition to manual therapy, those patients in pain are encouraged to also participate in other treatments, such as an exercise program. This usually includes strengthening exercises and stretching and low-impact aerobic conditioning. A physiotherapist will provide exercises during treatment and also provide you with home exercises. With the proper hands-on therapy and exercises, pain should be lessened and the range of motion should be restored.

If you’re in pain or have limited activity to do a medical condition or injury, a physiotherapist can be your lifesaver. Give us a call today at Kitchener, Waterloo & Elmira, ON Centers to schedule an appointment for a consultation and comprehensive evaluation. Our physiotherapists are certified, trained and experienced. They’ve helped many on the road to recovery and can help you too.



    Belmont Centre for Physical Medicine
    564 Belmont Avenue West, Suite 301
    Kitchener, Ontario N2M 5N6

    Phone : (519) 743-4355 Fax : (519) 743-6787


    Behind Wellness Centre ( Clock Tower )
    3 Wyatt Street East, Suite 2
    Elmira, Ontario N3B 2H4

    Phone : (519) 669-1212 Fax : (519) 669-0800


    University of Waterloo Student Life Centre
    200 University Avenue West
    Waterloo, Ontario N2L 3G1

    Phone : (519) 884-0767 Fax : (519) 884-9161