Manipulation, for physical therapy, is a type of passive movement of a skeletal joint. Usually, it aims at one or more ‘target’ synovial joints–like the shoulder, knee, hip, or elbow–with the aim of achieving a therapeutic effect.
This technique is distinguished from other Manual Therapy interventions, such as joint mobilization, by its biomechanics, both kinetics and kinematics.
Joint manipulation is characteristically associated with the production of an audible ‘clicking’ or ‘popping’ sound. This sound is believed to be the result of a phenomenon known as cavitation, occurring within the fluid of a synovial joint. When performing a manipulation, it involves applying force to pull apart the surfaces of a joint that is fully enclosed by a capsule. This action stretches the joint capsule and the tissues inside the joint, decreasing the pressure within the joint.
The clinical effects of joint manipulation include:
- Temporary relief of muscle and joint pain
- Shortened time to recover from acute back sprains
- Temporary increase in passive range of motion
- Physiological effects upon the central nervous system
- No alteration of the position of the sacroiliac joint
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