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Three techniques of manual therapy - from classics to innovative methods

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Everyone who suffers from spine diseases has probably heard about rotational techniques as the most common techniques of manual therapy. However, popularity is not always a synonym for efficiency and safety. Doctors in the process of many years of practice, analyzing the results of treatment, increasingly pay attention to the risk of injury to the spine with rotational twisting. However, rotation is not the only method used by doctors. And in each specific case, the first priority is to find the right and safest way of treatment.

The specialists of the clinic "The Institute of Vertebrology and Rehabilitation", which specializes in the non-surgical treatment of back and joints, told what alternatives exist to the methods of twisting, and what are the pros and cons of each of them. In addition to traditional rotations, we will consider tractional (distractive) techniques and the method of short leverage.

Classical rotary techniques

Rotational techniques are techniques aimed at twisting the spine. They are widely used all over the world. Spinning the spine helps to increase its flexibility, improve blood circulation, correct posture and restore mobility to the joints.

Rotation, as mentioned above, is a "classic" of manual therapy. They refer to aggressive techniques, since their implementation provides for active use of force against the spine (local effects are excluded) and in some cases may be quite painful. For this reason, rotational techniques can be used as a therapeutic procedure only in cases where there is no threat of traumatizing the spine, and also when there are no other medical contraindications.


Contraindications to the implementation of rotational twists are herniated intervertebral discs, any neoplasms (cancer or hemangiomas) and post-traumatic problems of the spine (for example, compression fracture). Rotational techniques are also not recommended for use in the postoperative period, especially when stabilizers or fixators are installed on the spine (special designs that connect the vertebrae to each other).


Improper performance of rotational twists and neglect of contraindications can provoke spinal trauma (fractures or rupture of ligaments), blocking the spine segment, compression (compression) of the radicular structures. If the patient is diagnosed with a hernia, the use of rotation can lead to its sequestration - separation from the base of the intervertebral disc and falling into the canal.

Traction (distraction) techniques

Tractional (distraction) techniques refer to low-traumatic soft techniques and are aimed at stretching the damaged structure of the spinal column. The procedures are done on special tables - horizontal or vertical. Stretching the spine allows not only to increase the distance between the vertebrae, but also improves blood circulation and muscle tone, helps to get rid of the compression of radicular structures.

Depending on the department of the spine, on which the traction effort is directed, distinguish cervical, thoracic and lumbar tractions.


Applying traction techniques for spinal correction is contraindicated in the presence of posttraumatic problems (for example, compression fracture) and large neoplasms (cancer tumors, hemangiomas). Stretching of the spine is also unacceptable when the spinal cord circulation is impaired.


Traction techniques are considered less effective than rotational techniques and short-arm method. In particular, they will not be effective in cramping and severe pain syndrome. In some cases, with the use of traction, there may be a shooting - a sharp sharp and sudden pain in the back (most often in the lumbar region).

Short-arm method

The method of a short lever is the action by hands, fingers or hands directly on the body, arches and spines of the vertebrae. This is an innovative soft technique that completely excludes the rotational mechanism and implies an extremely precise impact on the segment that is blocked or displaced

This method can be used even in the presence of osteochondrosis, protrusions or large hernias, as well as after operations, provided that the fixatives (fixers) are in other parts of the spine. The short arm method allows you to unlock the immobilized segment of the spine and restore the normal position of the vertebrae with high accuracy. Due to high efficiency, positive changes are noticeable after the first session.


The main and almost the only contraindications for the application of the method are fractures (for example, compression or fracture of the vertebral column), neoplasms of oncological character or large hemangiomas. Unlike rotary and traction techniques, the short arm method is locally directional and can be applied if necessary only in the desired department. This means that it can be used even during the postoperative period and in the presence of stabilizers and fixators (the structures that connect and fix the vertebrae) in other parts of the spine.


The short arm method is the safest of the above listed and completely eliminates all sorts of risks such as pain, trauma, and compression.

Despite the seeming simplicity of performing methods for correcting the spine, these procedures require absolute accuracy of performance and vast experience and knowledge. Therefore, it is extremely important that professionals treat professionals. A visit to a doctor with insufficient qualifications can lead to poor health, and in some cases may result in a fracture or displacement of the vertebrae. In addition, only a specialist will be able to correctly diagnose and select the correct method of treatment and rehabilitation in order to permanently consolidate the result. With any problems of the back, it is recommended to contact a specialized medical institution, where it is possible to provide professional examination, treatment and rehabilitation.

The Institute of Vertebrology and Rehabilitation is the leader in the field of back care for 17 years. In more than 95% of cases, patients of the Institute get rid of spine diseases without surgery. During the treatment, soft techniques of spine correction are used: traction (distraction) techniques, as well as short-arm method. Classical aggressive rotary techniques, due to their increased degree of traumatic danger and much less accurate impact, the clinic doctors are not used.

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