Manual therapy
Targeted treatment of joints and muscles using the hands: we examine which structure is restricting movement, release it and secure the result with exercises.
When manual therapy makes sense
When a joint no longer moves through its full range, a movement locks up, or a pain returns with every rotation, we work on the joint function itself – not just on the muscles around it.
Restricted movement
The arm no longer reaches above shoulder height, the head cannot turn far enough when looking over the shoulder, the knee does not fully extend. We identify which joint structure is limiting the range and expand it step by step.
Blockage
A movement suddenly locks and hurts at a very precisely describable point. Such conditions often affect small facet joints, the sacroiliac joint or the rib joints.
Pain under load
Complaints that reliably recur with certain movements – when climbing stairs, standing up from a chair or chewing. Here we examine joint play and muscle tension together.
How we treat
It starts with an assessment: we move the joint passively through its range and compare both sides before selecting a technique.
At the start, we check the mobility of your joints and the condition of the surrounding muscles to narrow down the cause of your symptoms. Building on this, we use targeted manual techniques to release blocked and stiff joint structures. Afterwards, we work with you on stabilising exercises so that the mobility gained is maintained in everyday life.
The techniques are applied gradually and agreed with you. Anything that isn't comfortable during the session is stopped, and we choose a different approach.
What happens in a session
- Discussion of progress since the last appointment
- Movement assessment comparing both sides, active and passive
- Mobilising manual techniques on the affected joint
- Treatment of the muscles that guide the joint
- Two to three exercises for home, practised together
- Brief note on what's planned before the next appointment
Typical patterns of complaint
Most people come to us with neck and shoulder issues – but the same principles apply from the jaw joint to the foot.
- Neck and shoulder: restricted shoulder check, tension headache originating from the cervical spine, painful arc when lifting the arm
- Jaw joint: clicking when opening, limited mouth opening, symptoms after dental treatment or nighttime clenching
- Hip and knee: start-up pain after sitting, restricted hip rotation, stiff knee after immobilisation
- Spine: movement-dependent lower back symptoms, sacroiliac joint, rib joints during deep inhalation
- Elbow, wrist and hand: symptoms after prolonged use of a keyboard or tools
- Ankle and foot: after a sprain, when mobility doesn't return
Manual therapy and physiotherapy compared
Both approaches work with movement, but they address different points – doctors often prescribe them one after the other.
Manual therapy
- Approach at the joint itself: joint play, capsule, surrounding structures
- Suitable for blockages and clearly defined limits of movement
- Therapists with the corresponding additional qualification
- Requires its own medical prescription
Physiotherapy
- Approach via active movement, strengthening and coordination
- Suitable after surgery, for postural complaints and in aftercare
- Builds on the mobility gained in manual therapy
- Less direct effect on a single blocked joint
Bring your prescription
Frequently asked questions about manual therapy
Explore related topics
Many prescriptions combine manual therapy with a second treatment – these pages explain what goes well together.
Process
How a session works
In a manual therapy session, we first assess your symptoms and examine the affected joints and muscles before working specifically on the cause using gentle hand techniques. A session typically lasts 20 to 25 minutes.
Four steps per appointment
Brief conversation
We ask about your symptoms since the last appointment: where it pulls, which movements are difficult, and how your body responded to the previous treatment. During the first session, we also take extra time to discuss your medical history, any operations, and the doctor's prescription.
We ask about your symptoms since the last appointment: where it pulls, which movements are difficult, and how your body responded to the previous treatment. During the first session, we also take extra time to discuss your medical history, any operations, and the doctor's prescription.
We check mobility, joint play and muscle tension in comparison with the other side and identify which structure is limiting movement. This determines which area we work on during this session – often not the spot where it hurts.
This is followed by joint mobilisation, techniques for muscles and connective tissue, and, where appropriate, traction to relieve pressure. We adjust the intensity so the treatment is comfortable for you, and check in with you throughout.
Finally, we show you one or two exercises to maintain the results between appointments. We practise them together and note the repetitions and frequency in writing, so no questions remain once you're at home.
Questions about: Physiotherapy, manual therapy
Briefly describe what you need – Physiopraxis Nord will get back to you with an assessment.