In thrust techniques we hear the cavitation and can perform a post-treatment palpation to confirm the improvement. However, palpation of release becomes a sensitive ally in PIR, fascial and skin techniques as well. For example, in PIR or muscle energy techniques for joint restrictions we first take up the slack and engage the barrier. Then we ask the patient to gently contract against our resistance away from the barrier. After a brief isometric effort, usually combined with synkinetic breathing and eye movements, the patient is asked to relax and we wait.
Manipulation is essential to rehabilitation of the motor system.
Remedial exercise is time consuming and time should not be wasted. References Lewit K. Manipulative Therapy in Rehabilitation of the Motor System, 2nd edition. Inefficient muscular stabilization of the lumbar spine associated with low back pain. Static back endurance and the risk of low-back pain. Ng J, Richardson C. Reliability of EMG power spectral analysis of back muscle endurance in healthy subjects.