Manual therapy

The targeted application of specific manual techniques


Manual therapy is a form of therapy in which hands are treated. This form of treatment is a specialization of physiotherapy and has its origin in chiropractic and osteopathy. The aim of the therapy is to (re) get the mobility of all the movement chains of the body and in particular of the spine. The way this happens can be both ‘soft and gradual’ and ‘hard and abrupt’. You will be asked for permission to apply the harder manipulative techniques (SMT; spinal manipulative therapy).

The treatment focuses on the entire movement chain


Manual therapy is an essential part of the treatment at Fysio Quality. If the movement disorder is causally related to the patient’s health problem, manual therapy is a very effective and valuable intervention within the treatment plan. Although in most cases there is an immediate effect, the body may have to recover from the treatment for several days. The effects are increased mobility, reduced resistance during movement and a decrease in pain. In addition, there are indications that manual therapy also has a positive effect on the immune system.

It is important to immediately use the obtained mobility, so that the mobility is maintained (use it or lose it). For this it is important to perform the prescribed exercises several times a day. Increasing the load capacity through strength training can be a way to prevent complaints from coming back. Functional training or sports rehabilitation provides renewed confidence in movement and improved movement efficiency.

The Manual therapist


In addition to the ‘well-known’ techniques that every manual therapist learns during his training, we also apply various other manual treatment techniques at Fysio Quality.


  • Mulligan manual therapy. Taught personally by Brian Mulligan. This is a form of manual therapy in which the limited and painful movement is ‘corrected’ in the movement in a quiet way.
  • The ‘harmonic technique‘. Taught personally by Lederman. This gentle osteopathic mobilization is relaxing and effective.
  • Muscle Energy Technique. Taught personally by Leon Chaitow.
  • Spinal Manipulative Therapy (SMT). Personally taught by Joshua Cleland & Louie Puentedura. This is a harder form of manual therapy.


Specific expertise of manual therapy


Manual therapy can be effective for complaints * to:


  • the spine
  • the ribs (such as tietze syndrome)
  • the pelvis (such as instability or sacroiliac blockages)
  • the neck with radiation and / or tingling to the arm and / or head  (Hoving et al)
  • headache (Castien et al)
  • the back sometimes with radiation and / or tingling to the leg
  • the shoulder sometimes with radiation to the upper arm and hand, with or without movement restrictions (Bergman et al)
  • on the wrist
  • of the hip and groin, possibly with restricted movement (Hoeksma et al)


* Fysio Quality treats children from 2 years with manual therapy.




The impact of dizziness can be significant. When the dizziness leads to falls, the consequences for the elderly in particular can be very great. The risk of absenteeism is particularly present in the case of vertigo. A good diagnosis is therefore very important. A number of dizziness can be treated well. In most cases, the diagnosis can be made by hearing the story. In particular, BPPD (Benign Paroxysmal Position Dizziness) and cervicogenic dizziness can be influenced quickly by manual therapy. With vertibular neuritis (inflammation of the inner ear), recovery will take longer. Vestibular rehabilitation can help to recover from the complaints. In most cases, tests are done by the specialist first. Fysio Quality has been registered with the Dizziness Knowledge Center since 2015.

Participation in scientific research


By regularly participating in scientific research, Fysio Quality is kept informed of the latest state of affairs.

In recent years we have participated in:

The neck study.

Sidney Rubbinstein


De MCM studie (Monitoring Cervical Manipulations : a prospective cohort study).

Rick Kranenburg.


The Go4safe study.

Rogier de Best.

Increased immune response in patients with chronic neck pain.

Ivo Lutke Schipholt.





Possible complications


Before manipulating the neck, the manual therapist examines whether there is an increased risk of complications. If the manual therapist has any indication that there is an increased risk, he will advise against manipulation as a form of therapy for the neck. However, the study cannot fully exclude the risks of manipulation.


Research shows that in very rare cases * after neck manipulation, serious complications such as damage to blood vessels occur, with the possible risk of stroke or even death. These rare negative side effects and side effects have been reported in particular when making movements high in the neck. There is also a small chance of damage to the nerves, bones, muscles or connective tissue. Manipulating the neck can also put some pressure on the arm nerves.


Manual therapists are trained to know when and where to apply the manipulation technique. They are experts in the safe and effective application of these techniques. If there is even the slightest indication that you are at risk, the manual therapist will suggest other treatment techniques such as mobilizations.


* The risk of serious complications is estimated between 1 in 50,000 to 5.8 million manipulations.

Do you want to return to your old level? Or better?!