Manual Therapy at Home in Bibwewadi, Pune

Manual therapy covers the treatments that use the physiotherapist's hands: moving a stiff joint through small, controlled movements, working on tight muscles and stretching a restricted area. Our manual therapy page covers the techniques generally. This page explains how it works at home in Bibwewadi, where the bed and the floor take the place of the clinic's treatment table.

What hands-on treatment can and cannot do

Used well, manual therapy can reduce pain and increase movement in the short term. Stiff joints in the neck, back, shoulder or hip often move more freely afterwards, and that window of comfort makes exercise easier. The evidence supports its use for some conditions, especially neck and low back pain, when it is combined with exercise. Alone, its effects usually do not last. We therefore treat it as a way of making the exercise work, not as a substitute for it.

It does not change anatomy permanently, and it does not realign bones, whatever you may have heard. What it appears to do is influence pain through the nervous system and reduce protective muscle tension.

Treating on a bed or a floor mattress

Because the visit is at your home, the physiotherapist works with what is there. A bed of the right height lets us treat the back and hip while standing comfortably, and a firm mattress on the floor works if the patient can get down and up safely. A sofa is usually too soft. If the bed is too low, we may ask you to sit on a chair for neck and shoulder work, or place the mattress on a firmer base. For older patients who cannot lie flat, treatment is done sitting. Please clear a space about the width of the bed, and wear loose clothes.

What the physiotherapist will do

• Joint mobilisation. Slow, graded movements of a joint, such as a spinal level or the shoulder, within your comfort.
• Soft-tissue work. Pressure and stretch along tight muscles, which overlaps with myofascial release.
• Stretching and traction. Gentle lengthening of a restricted joint or muscle.
• Manipulation, selectively. A quick, small movement, used only if the physiotherapist is trained, you are suitable and you agree.

After treatment, you will usually be asked to test the movement that was limited, and then given exercises to practise it. Without them, the stiffness tends to return.

When manual therapy is not suitable

The physiotherapist screens for conditions in which hands-on treatment could do harm. These include:

• a suspected fracture, an unhealed fracture or recent major trauma;
• osteoporosis or thin bones, where force is limited or avoided;
• signs of a serious spinal problem, such as progressive weakness or loss of bladder control;
• infection, a known or suspected tumour in the area, or unexplained weight loss;
• a clot in a vein, or a hot, swollen, painful calf;
• neck pain with dizziness, double vision, slurred speech, fainting or a sudden severe headache, which are reasons for emergency assessment, not neck treatment.

Treatment is also adjusted if you are on blood thinners, pregnant or have a joint replacement. Tell the physiotherapist at the start.

Stiff necks and tight hips in a Bibwewadi week

Two complaints come up often in the area: a stiff neck after long hours looking down at a laptop or a screen, and a tight lower back and hips after hours in a car or on a bus. These respond well to hands-on treatment plus a short routine of movement. If your problem is mostly in the knee or the shoulder, read knee pain physiotherapy or frozen shoulder physiotherapy, where manual therapy is one part of the plan.

After a session

• Mild soreness for a day is common, like the day after exercise. A warm shower helps.
• Do the movements you were shown, and avoid forcing the joint.
• Tell the physiotherapist how you felt over the next day, because it guides how firmly to treat next time.

To arrange a visit, use the booking page, or see the Bibwewadi hub for the areas we cover.