Hands-On Physiotherapy

What is hands-on physiotherapy?

Hands-on physiotherapy, otherwise known as manual therapy, is loosely defined as the use of the hands on the body with therapeutic intent. Hands-on physiotherapy primarily involves using the hands to apply pressure and movement to the body to treat aches, pain, and injuries. Forming the foundation of our physiotherapy philosophy and of the physiotherapy discipline itself, our team is experienced in hands-on techniques to assess and treat pain and injury. Our team is highly skilled in all treatments whether approaching aches, pains, and injuries in your joints, muscles, nerves or connective tissue.

Treating pain and injury is complicated because the body is complicated. Therefore, it can be hard to treat the cause of your symptoms without using your hands and hands-on techniques to get a sense of the body and to manipulate it in such a way that stimulates the healing process.

We will perform an initial assessment which will make clear to your physiotherapist the complications in joints, muscles, nerves and connective tissue you may be experiencing. Restrictions in movement, reduction of strength, the tendency of certain areas to experience more pain, and how areas that may not be at issue with you may be contributing to your issues, will all be assessed to ascertain the nature of your complications.


What is included in the physiotherapy consultation?

At City Physiotherapy Adelaide, your hands-on physiotherapist will utilise a comprehensive range of individual treatments to restore your physical function, health, and wellness. We will enhance your physical wellbeing and body movement to have you feeling better than ever before.

The hands-on/manual techniques that our physiotherapists may utilise to individualise your treatment, however, knowing every person is different, and every person’s symptoms may respond to different physiotherapy treatments, our team will choose the techniques that will best suit you after the initial examination.

For your initial physiotherapy consultation, your physiotherapist will begin by performing an initial examination through conversation and diagnostic movement. This information is used to generate an individualised, hands-on, treatment plan that will guide you towards a fast recovery. Our aim is to partner with you to make you feel better and to help you stay that way.

To start, your physiotherapist will discuss the history of your core problem or injury, factors such as occupation, involvement in sports, physical habits, etc.

Next, our physiotherapists may ask you to perform certain movements as part of your physical examination.

These physical tests determine things such as your:

  • Range of Motion (mobility and flexibility)
  • Strength
  • Ligament and Joint stability
  • Swelling
  • Palpation (what is tender to touch)
  • Reflexes, sensations
  • Nerve Tests

Your physiotherapist is highly skilled at palpation of your joints, muscles, nerves and connective tissue in order to assess the best course of treatment for your aches, pains and current symptoms.

There are, nonetheless, three main manual techniques we utilise that comprise the bulk of our hands-on treatment which are joint mobilisation, massage, and stretching.

Joint mobilisation and manipulation

Joint mobilisation and manipulation is a technique where your physiotherapist uses a controlled amount of force to move the segments of your joint. When joints become dysfunctional as a result of trauma, overuse or disuse, they are unable to perform the movements for which they were designed. Joint mobilisation is technique physiotherapists use to restore the small, involuntary movements that assist joints to perform to their optimum. Joint mobilisation involves performing a back-and-forth oscillation of the joint in order to restore motion.

A mobilisation becomes a manipulation when your physiotherapist performs a high-velocity thrust through your joint and a ‘popping’ sound may be heard. Joint manipulation is characteristically associated with the production of ‘pop’ or ‘click’ sounds. This sound is believed to be the result of a phenomenon known as cavitation.

When a joint manipulation is performed, space is increased within the joint cavity, which in turn creates a reduction in pressure. In this low-pressure environment, some of the gases that are dissolved in the synovial fluid, create a bubble or cavity. It rapidly collapses upon itself, resulting in a ‘clicking’ sound.

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

  • relief of musculoskeletal pain
  • unlocks joints, e.g. stiff neck/acute back sprains
  • improves joint range of motion

Soft tissue massage, trigger point massage, and deep tissue massage.

Soft tissue, trigger point, and deep tissue massage are the three main types of massage we utilise during hands-on physiotherapy, among remedial massage which is akin to the massage you might be familiar with. All types of massage:

  • alleviate a range of aches, pains and injuries.
  • are targeted to specific points discerned through the initial physical examination. These points are usually responsible directly or indirectly to the aches, pain, or injury you may be suffering from.
  • involve direct physical contact of our physiotherapists’ hands with a patient’s body, in varying degrees of intensity.
  • help the body’s recovery process from injury by stimulating blood flow and reducing the pain and inflammation of the targeted area/s. 

Deep tissue massage

Deep tissue massage is particularly helpful for muscle strains and sports injuries. It involves consistent pressure applied with slow, deep strokes targeting the deeper layers of the muscles and the connective tissues. This helps to break up any scar tissue that has developed after an injury, reducing pain and tension. 

Soft tissue massage

Soft tissue massage is less intense and painful than deep tissue massage. Rather than focusing on deep, slow, and strong strokes to the body, this massage technique uses a variety of pressures and durations. Soft tissue massage helps to reduce stress, improve mental health, and help people feel more relaxed. Soft tissue massage is generally gentler than deep tissue massage so is often preferred by people with lower pain tolerances, and to enjoy the relaxation effects of massage.

Trigger point massage

Trigger point massage used the hands and fingers to directly apply to “trigger points”—specific parts of the body that are contributing to or causing aches, pain, or injuries. These trigger points can be tightness or sensitivity and are caused by stress, poor posture, injury, or joint disorders. This type of massage is founded on the tendency for the body to refer pain—the body transfers pain from one location to another. Trigger points are usually found to be the culprit for pain that’s cause can’t be determined.


Stretching is used to lengthen the muscle to improve its flexibility and elasticity. The root cause of pain and injury can be tight muscles especially when the tightness compromises typical body mechanics. We will often use this in conjunction with the treatments above to 

Stretching may seem like a no-brainer but often adherence to stretching regimens after treatment is minimal. A lot of people are averse to stretching, and it can be difficult but usually, when it comes to painful activities regarding the body, like pulling a tooth, ripping a bandaid, etc., it is easier to get someone else to do it. This is called passive stretching—as opposed to active stretching where you yourself will apply the force—a technique utilised by your physiotherapist where they will apply force themselves. Passive stretching can reduce the discomfort of having to perform the stretch yourself, thus, the initial stretch will reduce the discomfort and tightness in muscle/s and reduce the barrier of entry for completing a stretching regimen we may provide to you. 


What hands-on/manual treatment techniques do our physiotherapists utilise?

Our team is made up of the best hands-on physios, and health and wellness professionals in Adelaide. We use a variety of manual treatment techniques together with cutting-edge physio treatment strategies, education and self-management advice including:

  • Soft tissue, trigger point & deep tissue hands-on physio treatment
  • Stretching and muscle release
  • Joint mobilisation & manipulation
  • Remedial massage/physio massage therapy
  • Trapped/pinched nerve pain physio treatment
  • Anti-inflammatory physio treatment
  • Strapping/sports taping
  • Bracing & splints
  • Pilates & core physio stability exercise classes and rehabilitation
  • Postural correction and endurance muscle training
  • Mindfulness and stress reduction techniques
  • Pain management
  • Post-surgery physio and sports injury rehab physio
  • Tendon rehab
  • Individual gym & clinical Pilates – reformer, trapeze & magic circle
  • Functional exercise rehabilitation and training
  • Hot and/or cold packs & electrotherapy
  • Running physio & sports physiotherapy enhancement – AFL/Australian Rules Football, Basketball, Soccer, Golf, Hockey, Swimming, Dance, Netball, Cricket, Tennis, Athletics, Cycling & more
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Some of the exercises will be performed initially with your physiotherapist before making them a part of your routine for recovery. We might recommend attending a class or give you a self-management program to do at home.

If required, your physiotherapist may also refer you for x-rays, diagnostic ultrasound scans, cortisone injections or digital MRIs. We may also discuss ways in which you may reduce inflammation in your body through medication or natural supplements. We will work closely with other health providers, GPs and specialists to assist in reducing your pain consistently and comprehensively. Our primary focus is using hands-on treatment to get you back to feeling great in your work, rest and play.


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