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Orthopaedic manual therapy

physiotherapist does manual therapy on shoulder

Overview of orthopaedic manual therapy

physiotherapist manipulates shoulder of patient

Injuries, chronic conditions and post-surgery issues involving the bones, muscles, tendons or ligaments can not only cause you pain but also prevent you from participating in the regular activities you enjoy. You may feel restricted and frustrated, unable to move with the freedom you once did. 

There are physiotherapists who are trained to help with orthopaedic injuries and conditions like this that cause impairments or dysfunction to the bony and soft tissue structures of your body. They use various orthopaedic manual therapy techniques that are safe and effective at bringing pain relief and recovery of movement.

If you’re dealing with orthopaedic pain and restriction, it’s worth learning more about your options.

What is orthopaedic manual therapy?

Orthopaedic manual therapy or physical therapy (OMPT) is a type of physiotherapy used to assess and treat pain, stiffness and restricted movement caused by orthopedic injuries or conditions. It employs a variety of hands-on techniques that work on the spine, arms and legs, tailoring each exercise to your specific needs.

Note: In other online research, you may see “orthopedic” instead of “orthopaedic.” The former is the common American spelling. The two terms refer to the same thing—the branch of healthcare that deals with the correction of deformities or functional impairments of the skeletal system.


Who performs this type of physical therapy?

Orthopaedic manual physical therapy is a treatment performed by a physiotherapist, or PT. These are licensed healthcare professionals who have graduated from physical therapy programs from an accredited university, passed provincial board exams and have additional post-graduate training in manual therapy for orthopedic injuries and conditions.


physiotherapist pinches back of patient

What techniques are used in ortho physio?

Orthopaedic physio (or ortho physio) involves manually applied treatments that improve muscle and tissue function while relieving pain. Common techniques include:

  • Joint mobilization: A therapist will apply a rhythmic back and forth movement or sustained pressure to any affected joints in the body.
  • Joint manipulation: While you lie still, a therapist will apply a small, quick movement (such as a push or pull) to bones and joints. The movements can vary in terms of force, from gentle to forceful. Both joint mobilization and joint manipulation can help loosen any tight tissues connected to the joint, as well as decrease pain in the joint and surrounding areas. These techniques can also help improve flexibility and alignment, giving you back proper function.
  • Soft tissue mobilization: Treatments such as massage therapy and trigger point therapy are applied to muscles, tendons and ligaments. The focus here is on easing your pain while relaxing muscles, increasing circulation and breaking up scar tissue.
  • Myofascial release: Using light, manual pressure, a therapist will massage and stretch a trigger point in your fascia (the thin connective tissue that surrounds and supports your bones, organs, nerves, blood vessels and muscles). They may hold that point for a few minutes, then repeat the process a few times on each trigger point they find, until they feel a full release.
  • Other exercises: This can include muscle stretching, independent exercises (such as balance, endurance and plyometric and jumping-type exercises) and exercises with resistance from a therapist to improve muscle activation and timing. They will also teach you safe exercises you can do in between sessions, as part of a home exercise program, to help increase the speed of your recovery.

Ortho physio sessions generally last about 45-60 minutes. Therapists may incorporate certain tools into a session, such as exercise equipment, assistive devices or soft tissue massage instruments.


injured marathon runner sprained ankle

Conditions treated

Orthopaedic manual therapy is used to treat injuries and conditions affecting the musculoskeletal system, which is made up of your joints, muscles, bones, ligaments, and tendons. This means any injury or condition affecting the bony or soft tissue structures that causes you pain or restricts movement in your body can benefit from this therapy.

Common injuries and conditions that are treated with orthopaedic manual therapy may include:

  • Muscle strains
  • Ligament sprains
  • Joint restrictions
  • Post-operative conditions
  • Tendonitis
  • Bursitis
  • Athletic performance issues

In addition, orthopaedic manual therapy can also help minimize disability associated with conditions such as Parkinson’s disease, multiple sclerosis, cerebral palsy, spinal cord injury, diabetes, cancer, heart disease or balance disorders.

Orthopaedic manual therapy can be used both in the recovery and maintenance of your health.


mother and daughter hiking together

Benefits of orthopaedic manual therapy

For those dealing with acute or chronic conditions, orthopaedic manual therapy can reduce pain, improve posture and circulation, increase joint mobility, and minimize disability from disease progression. Ortho physio can also be combined with training and exercise to help athletes improve their performance.

Most individuals start experiencing the benefits of this treatment within the first few sessions. They leave the clinic feeling more relaxed and mobile than when they arrived.

The overall goal of orthopaedic manual therapy is to optimize the function of your body.


How is ortho physio different from other types of the therapy?

Ortho physio shares similar philosophies and techniques to massage therapy, chiropractic care and osteopathic therapies. However, ortho physio’s assessment, treatment and exercise programs follow a different approach. Your therapist will apply a cycle of continuous assessment, treatment and then re-assessment and adjusted treatment as you progress in your recovery. They will look for areas that restrict your mobility, as well as any muscles or joints that are compensating for those restrictions, and integrate changes into your treatment plan.


What about the cost?

Specific costs per session will vary depending on the clinic and your chosen physiotherapist. Most health insurance providers offer coverage of physiotherapy. Be sure to check with your provider to see if orthopaedic manual therapy is covered before seeking treatment.