Manual therapy is a treatment method used by athletic trainers, physical therapists and massage therapists. Generally, it is used to treat musculoskeletal pain and often includes joint manipulation, manipulation of muscles, soft tissue and joint mobilization. Physical therapy is a clinical approach to implementing hands-on techniques to increase the range of motion, treat joint structures, reduce pain, reduce inflammation, and enhance healing within the physical therapy profession. There are many different styles and manual therapy methods used by physical therapists.

Lower back stretching


Often, patients are instructed to treat pulled muscles with rest and massage. These methods work well, but the pain will likely return. That’s because the pain and muscle spasms result from a restricted joint. Joint mobilization used by physical therapists loosens up the restricted joint by applying slow velocity and increased amplitude. This type of manual therapy actually applies movement to the barrier of the joint. Joint mobilization is painless.

Soft tissue mobilization is used by physical therapists to break up fibrous muscle tissue and is often applied to the musculature surrounding the spine. This method of manual therapy entails rhythmic stretching and deep pressure. The physical therapist localizes the area of the greatest tissue restriction and begins to mobilize it with specific techniques, such as FAKTR and MFD.

The high velocity, low amplitude thrusting technique is a more aggressive approach that entails taking a joint to its restrictive barrier and actually thrusting it. This technique is used for the restoration of joint motion and does not move a joint beyond its normal anatomical limit. Although it is a more aggressive type of manual therapy, it does not cause pain.

The strain-counterstrain method focuses on fixing abnormal neuromuscular reflexes that cause postural and structural issues. The physical therapist will locate the patient’s position of comfort and hold that position for approximately 90 seconds. When holding, an asymptomatic strain is induced through stretching. The patient is then brought out of this position. This allows for a resetting of the muscles and sets the muscles for healing. It’s a gentle technique that is commonly used for back problems.

Muscle energy techniques (METs) are procedures used to lengthen shortened muscles and mobilize restricted joints. During this procedure, the patient’s muscles are voluntarily contracted against a controlled counterforce applied by the physical therapist from a specific direction. After the contraction, the joint is taken to its new barrier. This is an active procedure technique where the patient participates and is well-tolerated.


Before any physical therapist initiates manual therapy, a full assessment of the body is done in addition to a muscle and bone assessment. The physical therapist will then implement the best manual treatment for the patient. All around, manual therapy increases blood flow, reduces pain, increases the range of motion and just plain feels good. Contact us at Mesa, AZ center to learn more about how manual therapy can help you get on the road to recovery.

Five star review

I found Courtney and the cupping offered was just what I needed! It felt like an almost instantaneous fix. He helped me learn stretches and exercises to strengthen my shoulders for long-term results. My tendinitis has gotten a lot better but I still go in for cupping before meets or during heavy training. It keeps my muscles loose and keeps them from straining or tearing. All in all, Courtney has helped me out a lot in my athletic career.

– Jacob S.

Five star review

I was refereed to PR Lab by a friend. I came here on two different occasions to seek treatment 1) grade 2 lateral sprained ankle and 2) lower back strain muscle. Dr. Courtney Warren and Wendy were very thought with the treatment for both of these injuries. I was able to make a fast recovery and go back to my regular activities due to dry needling and cupping therapy. I highly recommend this place to anyone who seeks physical therapy or overall treatment for range of motion.

- Melissa S.