The three most notable forms of manual therapy are manipulation, mobilization and massage. Manipulation is the artful introduction of a rapid rotational, shear or distraction force into an articulation. Manipulation is often associated with an audible popping sound caused by the instantaneous breakdown of gas bubbles that form during joint cavitation. Mobilization is a slower, more controlled process of articular and soft-tissue (myofascial) stretching intended to improve bio-mechanical elasticity. Massage is typically the repetitive rubbing, stripping or kneading of myofascial tissues to principally improve interstitial fluid dynamics.
The differentiation between a manipulation and mobilization from a regulatory perspective is that a mobilization can be stopped at any point should the recipient decide to forgo the remainder of the procedure. On the other hand, a manipulation cannot be stopped by the practitioner once initiated.
Manual therapy can be defined differently (according to the profession describing it for legal purposes) to state what is permitted within a practitioners scope of practice. Within the physical therapy profession, manual therapy is defined as a clinical approach utilizing skilled, specific hands-on techniques, including but not limited to manipulation/mobilization, used by the physical therapist to diagnose and treat soft tissues and joint structures for the purpose of modulating pain; increasing range of motion (ROM); reducing or eliminating soft tissue inflammation; inducing relaxation; improving contractile and non-contractile tissue repair, extensibility, and/or stability; facilitating movement; and improving function.
The most widely recognized and commonly used category of massage is the Swedish massage. The Swedish massage techniques vary from light to vigorous. Swedish massage uses five styles of strokes. The five basic strokes are effleurage (sliding or gliding), petrissage (kneading), tapotement (rhythmic tapping), friction (cross fiber or with the fibers) and vibration/shaking. Swedish massage has shown to be helpful in reducing pain, joint stiffness, and improving function in patients with osteoarthritis of the knee over a period of eight weeks. The development of Swedish massage is often inaccurately credited to Per Henrik Ling, though the Dutch practitioner Johann Georg Mezger applied the French terms to name the basic strokes. The term “Swedish” massage is actually only recognized in English and Dutch speaking countries, and in Hungary. Elsewhere the style is referred to as “classic massage”.
Clinical studies report that Swedish Massage can effectively reduce low back pain and the effectiveness can last for as long as 15 weeks. One study reported that Swedish Massage caused reduction in salivary cortisol indicating its role in management of stress and improvement in mood.
Myofascial release refers to the manual massage technique for stretching the fascia and releasing bonds between fascia, integument, and muscles with the goal of eliminating pain, increasing range of motion and equilibrioception. Myofascial release usually involves applying shear compression or tension in various directions, or by skin rolling.
Manual lymphatic drainage is a technique used to gently work and stimulate the lymphatic system, to assist in reduction of localized swelling. The lymphatic system is a network of slow moving vessels in the body that carries cellular waste toward the heart, to be filtered and removed. Lymph also carries lymphocytes, and other immune system agents. Manual lymphatic drainage claims to improve waste removal and immune function.
Pediatric massage is the complementary and alternative treatment that uses massage therapy, or “the manual manipulation of soft tissue intended to promote health and well-being” for children and adolescents.
Postural Integration is a process-oriented bodywork combining deep tissue massage with breathwork, body movement and awareness as well as emotional expression.
Also known as manual therapy, manipulative therapy, or manual & manipulative therapy, this is a physical treatment primarily used on the neuromusculoskeletal system to treat pain and disability. It most commonly includes kneading and manipulation of muscles, joint mobilization and joint manipulation.
Trigger point therapy
Sometimes confused with pressure point massage, this involves deactivating trigger points that may cause local pain or refer pain and other sensations, such as headaches, in other parts of the body. Manual pressure, vibration, injection, or other treatment is applied to these points to relieve myofascial pain. Trigger points were first discovered and mapped by Janet G. Travell (President Kennedy’s physician) and David Simons. Trigger points have been photomicrographed and measured electrically. and in 2007 a paper was presented showing images of Trigger Points using MRI. These points relate to dysfunction in the myoneural junction, also called neuromuscular junction (NMJ), in muscle, and therefore this modality is different from reflexology, acupressure and pressure point massage.
While various types of reflexology related massage styles focus on the feet, massage of (usually) the soles of the feet is often performed purely for relaxation or recreation. It is believed there are some specific points on our feet that correspond to different organs in the body. Stimulation of these points during foot massage can cause significant reduction in pain. Studies also suggest that foot reflexology massage can reduce fatigue and promote better sleep.
Craniosacral therapy (CST) is a gentle approach that releases tensions deep in the body by applying light touch to the skull, face, spine, and pelvis.