Manual Therapy | Physio Island

What manual therapy is & why we use it

Manual therapy is targeted, hands-on treatment to joints, muscles, and fascia. It helps calm pain and protective tension, improves mobility, and makes exercise more comfortable and effective.

Short-term pain relief and mobility gains
Prepares you for targeted exercise
Individualized to your condition and goals
Best outcomes when combined with education & loading

What to expect

Clear explanation; gentle start, then progress as tolerated
Options adjusted for sensitivity (position, pressure, duration)
Always followed by simple exercises to “lock in” change
Mild post-treatment soreness for 24–48 hours can be normal; we’ll show you how to manage it.

Before & after your visit
Drink water, keep moving gently the same day, and use light heat/ice if needed. We’ll give you simple home steps to manage any post-treatment soreness.

Techniques we may use

Joints

Maitland & Mulligan joint mobilizations (Grades I–IV, MWM)
Segmental & rib mobilizations; lumbar/thoracic techniques
SIJ & hip mobilization; ankle/foot, wrist/hand techniques
High-velocity techniques used selectively, with consent.

Soft Tissue & Fascia

Myofascial release, trigger point pressure
IASTM/Graston (instrument-assisted) for tissue glide
Cupping (decompression) to improve tissue excursion
Scar & cross-friction techniques when appropriate

Neuro & Support

Nerve glides (median/ulnar/radial, sciatic/tibial)
PNF & muscle energy techniques (MET)
Taping (rigid/Kinesio) for comfort and cueing
Breathing & relaxation strategies

* Techniques are tailored to you and used only when clinically appropriate.

Techniques — quick guide with images

IASTM / Graston

Stainless-steel instruments glide along superficial fascia and muscle to reduce tension and improve tissue mobility and range of motion.

Reduces friction and improves tissue glide
Modulates pain and supports ROM
Follow with 2–3 exercises to make gains stick

Silicone cup applied to the upper back for decompression

Cupping (Decompression)

Gentle negative pressure lifts tissue, increases local circulation, and improves skin–fascia glide. Can be static or sliding.

Adjustable dosing for sensitive areas
Temporary marks can be normal
Finish with mobility drills

Myofascial Release

Soft-tissue techniques that target muscle and surrounding fascia to calm pain, reduce protective guarding, and improve movement quality.

Reduces protective muscle tension
Enhances movement comfort and control
Often paired with breathing/relaxation strategies

Physiotherapist performing shoulder joint mobilization

Joint Mobilizations

Rhythmic, targeted oscillations and glides (Maitland/Mulligan) to reduce pain and improve joint play and motion.

Grades I–IV and MWM variations
Short, focused dosing
Follow with active motion and loading

Trigger point pressure applied to forearm extensors

Trigger Point Release

Focused pressure to sensitive bands/trigger points to settle referred pain and normalize muscle activation.

Gradual pressure within comfort
May be combined with dry needling when appropriate
Finish with stretch/activation work

Taping

Rigid taping and K-tape can provide short-term support and sensory cueing to reduce pain, improve joint alignment, and remind you of good movement patterns during activity. Taping offers short-term support and proprioceptive cueing; it’s not a substitute for rehab/exercise.

Rigid protects the joint; K-tape wakes up the sensors.
K-tape can “turn down” pain signals
Taping can help fluid move out of puffy areas after minor injuries

Common problems we help

Spine & Head

Neck pain, cervicogenic headache
Thoracic stiffness, low back pain
Postural strain and desk-related pain

Upper Limb

Rotator cuff/shoulder impingement
Tennis & golfer’s elbow
Wrist/hand overuse & TFCC irritation

Lower Limb

Knee pain (PFPS, jumper’s knee)
Hip/gluteal pain, trochanteric bursitis
Ankle sprain, plantar fasciitis, Achilles pain

Joint Mobilization IASTM/Graston Cupping Trigger Point Taping

How we use manual therapy in your plan

Hands-on to settle pain & improve movement
Immediate follow-up with 2–4 key exercises
Progressive loading for strength and tolerance
Posture/ergonomics and pacing for day-to-day control
We track objective changes each visit (ROM, strength, function)

Plan of care (typical ranges)

Acute flares: 3–6 visits across 3–5 weeks.

Persistent pain/stiffness: 6–10 visits across 6–10 weeks.

Complex/long-standing cases: 8–12+ visits across 8–12+ weeks.

We reassess each session (pain, range of motion, strength, function). If progress stalls for 2–3 visits, we adjust the plan or coordinate with your physician.

Safety & when we avoid certain techniques

Manual therapy is safe when applied by trained clinicians and tailored to you. Soreness for 24–48 hours can be normal, especially early on.

We modify/avoid if you have

Acute fracture, infection, open wound or active cancer at the site
Severe osteoporosis or inflammatory flare
Neurological red flags, progressive weakness or numbness
Anticoagulants/bleeding disorders (for soft-tissue/cupping)

Insurance & Direct Billing

Manual therapy is part of physiotherapy. In NL you can book directly—some plans may request a physician’s referral for reimbursement. We offer Direct Billing to many insurers and provide detailed receipts for others.

FAQ

Is manual therapy the main treatment?

It’s a tool, not the whole plan. Hands-on care reduces pain and stiffness so you can do the exercises that create lasting change.

Does it hurt?

You may feel pressure or stretch; we always work within comfort and adjust technique immediately if it’s too much.

Do you do Graston/IASTM and cupping?

Yes, when appropriate and with consent. We also teach simple self-care strategies for home between visits.

How quickly will I feel better?

Many notice short-term relief right away; durability builds as you progress exercises over weeks. We’ll set realistic milestones together.