Prior to beginning any kind of physical or manual therapy in Ottawa, the practitioner usually has to perform a full assessment of the nerve and blood supply in the area. They also have to assess the muscle and bone in order to decide whether there is a risk of developing complications from the use of manual therapy techniques. Depending on the outcome of the assessments, and the patient’s specific situation, the health practitioner may perform one or a combination of the following kinds of manual therapy techniques.


This method of manual therapy majors on correcting abnormal neuromuscular reflexes that cause postural and structural issues that result in painful tender points. The therapist identifies the patient’s position of comfort by asking them at what point the tenderness diminishes. The therapist then holds the patient in this position of comfort for about one and a half minutes during which time they induce asymptomatic strain through mild stretching. After that, the therapist then brings the patient slowly out of this position allowing the body to reset its muscles to a normal level of tension. This normal level of tension in the muscles sets the stage for healing. This manual therapy technique is gentle enough to be useful for back problems that are too delicate or acute to treat using other procedures. Most patients tolerate the strain-counterstrain quite well particularly at the critical stage because it positions the patient opposite of the restricted barrier and towards the position of greatest comfort.

Soft tissue mobilization

It is vital to recognize the role that muscles and their attachments in the joints play. Muscle tension decreases upon restoration of joint motion, but most of the time, the spasm will continue to be present. In such cases, the practitioner should address the muscle tension lest the joint dysfunction recurs. The aim of soft tissue mobilization is to break up fibrous or inelastic muscle tissue such as relax muscle tension, move tissue fluids, and scar tissue from injuries. Practitioners usually apply this procedure to the musculature surrounding the spine, and comprises of periodic stretching and deep pressure. The therapist localizes the area of the greatest tissue restriction through layer-by-layer analysis. Once they identify these restrictions, they will mobilize them with a broad variety of techniques. Often, these techniques involve placing a powerful force on the tight area with an attempt to restore normal texture to tissue and reduce associated pain.

Low amplitude, high-velocity thrusting

The aim of this manual therapy technique is to restore the gliding motion in joints, enabling them to close and open effectively. It is a more aggressive technique than joint mobilizations and muscle energy techniques that involves taking a joint to its restrictive barrier and thrusting it at a low amplitude of less than an eighth of an inch. If used properly, increased mobility and a decrease in muscle tone about the joint should be noticeable. This manual therapy technique is useful for restoration of joint motion and will not move a joint beyond its anatomical limit. As such, no structural damage occurs and the patient should be able to experience decreased pain after the treatment.

Joint mobilization

Patients diagnosed with a pulled muscle in their back often treat it with ice massage and rest. Although these techniques offer relief, it is temporary and often recurs because muscle spasm is in response to a restricted joint. Joint mobilization involves increasing the range of motion of the restricted joint by providing slow speed and loosening it up. These mobilizations should be devoid of pain unless the therapist approaches the barrier too aggressively.

Manual therapy techniques in Ottawa usually entail stretching and strengthening exercises as well as low-impact aerobic conditioning and should include reasonable maintenance exercises for patients to do on their own. The aim is to maintain the right type and level of activity and prevent pain from recurring.

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