Joint manipulation differs to joint mobilisation in terms of the technique used. Whereas joint mobilisation uses repetitive, oscillatory, gentle pressure to the joint in a specific direction, joint manipulation usually consists of four specific phases:
- Positioning of the patient into the most desirable orientation for joint manipulation
- Applying pressure to the area to be manipulated
- Applying a thrust force to the joint which results in manipulation. This is usually associated with a click or pop that can be heard from the joint (similar to cracking your knuckles)
- The unloading phase where the therapist releases the pressure
There are many theories regarding what the “clicking” or “popping” sound is that results from manipulation. Theories behind this remain inconclusive. What is known is that the process of manipulation is not detrimental to the joint and certainly isn’t “bone-on-bone cracking” which is a common misconception.
Joint manipulation is not a painful technique. You may feel slight discomfort or a sensation of increased pressure around the area being worked on and you may hear and feel a clicking. Typically, after treatment your physiotherapist will prescribe you with an exercise program to maintain or improve the increase in range that joint manipulation will have achieved.