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Manual Therapy

After the initial evaluation, we establish a plan of care with you that includes exercises that are indicated to alleviate your pain or dysfunction, postural education, instruct you in proper shoe wear if indicated, and utilize modalities as an adjunct to the manual therapy.

What is manual physical therapy?

Manual physical therapy is a specialized form of physical therapy delivered with the hands as opposed to a device or machine. In manual therapy, your therapist uses their hands to put pressure on muscle tissue and mobilize joints in an attempt to decrease pain caused by muscle spasm, muscle tension and joint dysfunction. Manual therapy can be helpful for the treatment of joints that lack adequate mobility and range of motion. This limitation can cause discomfort, pain, and an alteration in function, posture, and movement. Manual physical therapy involves restoring mobility to stiff joints and reducing muscle tension in order to return you to a more natural movement without pain.


All therapists at Keystone Physical Therapy are trained in and practice manual therapy employing the following techniques.

Soft Tissue Mobilization (STM)

The goal of soft tissue mobilization is to break up scar tissue, move tissue fluids and relax muscle tension. The therapist will find the area of greatest tissue restriction through layer by layer assessment. These restrictions can then be mobilized with a wide variety of techniques.

Joint Mobilization

Mobilization is a key component of manual therapy and consists of skilled, passive or active, movements to joints and their soft-tissue structures. Joint mobilization involves loosening  the restricted joint and increasing its range of motion by providing movement directly into the joint in ways patients cannot move the joint themselves.

Myofascial Release

Fascia is a specialized system of the body covering every bone, muscle and nerve in the body. Fascia is densely woven and looks somewhat like a spider’s web, connecting each and every part of the entire body to each other. When you experience trauma, such as a fall, the fascia becomes tight and restricted and can cause pain in other parts of the body. By applying gentle sustained pressure, and stretches, and long holds to the fascia, it releases restriction in the tissue, eliminating pain and restoring motion.

Proprioceptive Neuromuscular Facilitation (PNF)

A technique that promotes the response of normal movements of the body through stimulation of the sensory system responsible for detecting position and movement.

Passive Range of Motion (PROM)

Passively moving a joint through the normal range of motion.

Muscle Energy Techniques (MET)

Muscle energy techniques are designed to mobilize restricted joints and lengthen shortened muscles. MET focuses on joint range of motion limitation, and uses light to moderate muscular contractions to restore normal joint position and motion. By placing the affected joints in precise positions for soft tissue contraction and relaxation the therapist is able to inhibit restrictions within the muscular skeletal system.

Strain/Counter Strain

A treatment that enhances the biomechanics of the spine and peripheral joints, and eliminates inappropriate nerve activity and muscle spasms. By passively putting the joint into its position of greatest comfort, it reduces or eliminates the continuation of inappropriate proprioceptor activity. This allows the body to reset its muscles to a normal level of tension which sets the stage for healing.

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