Manipulation is a key practice performed in manual medicine used to restore proper postural balance of muscles, joints, and the body’s neural-musculoskeletal systems. It describes a treatment delivered to an identified orthopedic issue, such as a joint restriction or a soft tissue restriction, to restore normal, pain-free movement. Manipulation can also be used to describe a technique to restore motion of joints, muscles, and fascia. It may be used to restore motion to involved spinal joints, but can also be used to any extremity joint such as the shoulder, elbow, wrist, knee, and ankle to name a few.
Many people hear the term “manipulation” in medicine and think of manipulation in the context of a chiropractor cracking a patient’s spine to restore motion at a particular spinal segment. This is more appropriately termed manipulation with impulse or high velocity-low amplitude technique. This is just one of many techniques used by practitioners of manual medicine.
Manual medicine is as old as the science and art of medicine itself. There is strong evidence of the use of manual medicine dating back to ancient Egypt and other cultures in antiquity. Today manual medicine is practiced by a wide variety of health care providers including osteopathic physicians, allopathic physicians, physical therapists, chiropractors, massage therapists, and athletic trainers. Depending on the patient's complaints and medical history a wide variety of different manual treatments exist to restore pain free movement and balance to the musculoskeletal system.
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