Manipulation for physical therapy is a type of passive movement of a skeletal joint. It is usually aimed at one or more ‘target’ synovial joints with the aim of achieving a therapeutic effect.

Manipulation can be 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 synovial fluid of the joint. When a manipulation is performed, the applied force separates the articular surfaces of a fully encapsulated synovial joint. This deforms the joint capsule and intra-articular tissues, which in turn, creates a reduction in pressure within the joint cavity.

The clinical effects of joint manipulation have been shown to include:

  • Temporary relief of musculoskeletal 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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