The three most notable forms of manual therapy are manipulation, mobilization and massage. Manipulation is the artful introduction of a rapid rotational, sheer or distraction force into an articulation. The goals of manual therapy include relaxation, decreased pain, and increased flexibility. The term “manual therapy” refers to hands-on treatment of muscles, tendons, ligaments, and joints. Patients respond positively to hands-on work when combined with exercise and education. This leads to faster recovery and less out-of-pocket expenses.