Physio Hub:
Evidence-Based Article
The Efficacy of Joint Manipulation for Athletes
A practical, evidence-based overview for athletes and active individuals.
Joint manipulation — also called joint adjustment or spinal manipulation — is a manual therapy technique performed by physical therapists and chiropractors to restore mobility, reduce pain, and improve joint function. The treatment involves applying a controlled, high-velocity, low-amplitude force to a joint.
Although the exact mechanisms are still being studied, research consistently shows immediate short-term benefits, particularly for pain relief. Many people experience improvement lasting several days to a week.
Here’s what the science says about how joint manipulation works — and when it may help athletes.
How Joint Manipulation Works
While the full mechanisms remain unclear, current evidence suggests benefits may come from:
Neurophysiological Effects
-
activation of the body’s natural pain-modulating pathways
-
changes in how the brain processes pain and attention
-
reduced sensitivity in the spinal cord’s pain signaling networks
Mechanical Effects
-
improved joint mobility
-
improved spinal kinematics and movement quality
-
decreased muscle guarding
Collectively, these effects can reduce pain and temporarily enhance movement, making it easier for athletes to train or return to activity.
Is Joint Manipulation Helpful for Athletes?
Research findings are mixed, but several scenarios show promising evidence.
1. Strength & Performance
Spinal Manipulative Therapy (SMT) has been shown to:
-
improve strength output
-
enhance range of motion
-
reduce pain perception
These effects seem most relevant for strength athletes, where even small improvements in mobility or neural drive can make a difference.
2. Chronic Ankle Instability
Talocrural joint manipulation may help improve:
-
ankle dorsiflexion
-
functional performance
-
neuromuscular control
This makes it a potentially valuable tool for athletes in sports requiring quick cuts, jumps, and landings.
3. On-Field Acute Injuries
Some evidence supports using joint manipulation for:
-
acute spinal or rib pain
-
sudden mobility restrictions
—but only when screened and cleared by a trained clinician.
Manipulation is not appropriate for every situation, so proper evaluation is essential.
Can You Play Sports After an Adjustment?
Most athletes can return to activity immediately after treatment.
However:
-
some people may feel soreness or mild fatigue
-
therapists may recommend waiting up to 24 hours to ensure your body responds well
-
if manipulation was part of injury care, rest may be necessary
A safe rule: monitor your symptoms, and if the adjustment was part of rehab, avoid intense activity until cleared by your clinician.
Conclusion
Joint manipulation can be a useful tool — especially for pain relief, mobility improvement, and short-term functional enhancement.
However:
-
its benefits are typically short-term
-
it should not replace exercise-based rehab
-
proper screening is critical for safe use
For athletes, manipulation is best used strategically within a broader performance or rehabilitation plan.
< Recommendation by Our Experts>
✔ Use joint manipulation as a support tool — not a standalone solution
It can reduce pain and improve mobility, but long-term progress requires strength training, mobility work, and proper rehab.
✔ Work only with licensed professionals
A trained physical therapist or chiropractor can determine whether manipulation is appropriate and safe for your specific condition.
✔ Monitor your body post-adjustment
If you feel soreness or fatigue, wait up to 24 hours before returning to intense training. Let your body adapt before pushing performance.
< Reference >
- Lutke Schipholt IJ, Scholten-Peeters G, Bontkes H, Coppieters MW. Neuroimmune responses following joint mobilisation and manipulation in people with persistent neck pain: a protocol for a randomised placebo-controlled trial. BMJ Open. 2022;12(3):e055748. doi:1136/bmjopen-2021-055748
- García-Pérez-Juana D, Fernández-de-Las-Peñas C, Arias-Buría JL, Cleland JA, Plaza-Manzano G, Ortega-Santiago R. Changes in Cervicocephalic Kinesthetic Sensibility, Widespread Pressure Pain Sensitivity, and Neck Pain After Cervical Thrust Manipulation in Patients With Chronic Mechanical Neck Pain: A Randomized Clinical Trial. J Manipulative Physiol Ther. 2018;41(7):551-560. doi:1016/j.jmpt.2018.02.004
- Evans DW. Why is the prevailing model of joint manipulation (still) incorrect? Chiropr Man Therap. 2022;30(1):51. doi:1186/s12998-022-00460-2
- Haussler KK. Joint Mobilization and Manipulation for the Equine Athlete. Veterinary Clinics of North America: Equine Practice. 2016;32(1):87-101. doi:1016/j.cveq.2015.12.003
- Savva C, Karagiannis C, Korakakis V, Efstathiou M. The analgesic effect of joint mobilization and manipulation in tendinopathy: a narrative review. Journal of Manual & Manipulative Therapy. 2021;29(5):276-287. doi:1080/10669817.2021.1904348
- Isenburg K, Mawla I, Loggia ML, et al. Increased Salience Network Connectivity Following Manual Therapy is Associated with Reduced Pain in Chronic Low Back Pain Patients. The Journal of Pain. 2021;22(5):545-555. doi:1016/j.jpain.2020.11.007
- Martins DF, Sorrentino V, Mazzardo-Martins L, et al. Antihyperalgesic effect of joint mobilization requires Cav3.2 calcium channels. Mol Brain. 2023;16(1):60. doi:1186/s13041-023-01049-3
- Williams DrB. An Investigation into the Impact Spinal Manipulation May Have on the Performance of Strength Athletes: A Research Survey. IJRASET. 2022;10(7):1284-1291. doi:22214/ijraset.2022.45442
- Corso M, Mior SA, Batley S, et al. The effects of spinal manipulation on performance-related outcomes in healthy asymptomatic adult population: a systematic review of best evidence. Chiropr Man Therap. 2019;27(1):25. doi:1186/s12998-019-0246-y
- Kamali F, Sinaei E, Bahadorian S. The immediate effect of talocrural joint manipulation on functional performance of 15–40 years old athletes with chronic ankle instability: A double-blind randomized clinical trial. Journal of Bodywork and Movement Therapies. 2017;21(4):830-834. doi:1016/j.jbmt.2017.01.010
- Duquette SA, Kazemi M. The use of spinal manipulation to treat an acute on field athletic injury: a case report. J Can Chiropr Assoc. 2016;60(2):158-163.
Stay Informed with Physio Hub
Unlock a world of knowledge with our expertly curated articles on fitness, rehabilitation, and health & diet. Stay ahead with the latest evidence-based insights and practical advice. Subscribe now to receive updates and never miss out on new content!
