Hands-on clinical treatment · HSR Layout, Bangalore

Your pain has a
mechanical cause.
Hands-on treatment fixes it.

Manual therapy and advanced techniques applied with clinical precision — not as standalone treatments, but as targeted interventions integrated into your rehabilitation programme. Assessment-led. Evidence-graded. Measurably effective.

Joint mobilisation Spinal manipulation Soft tissue therapy Dry needling Cupping therapy Kinesiology taping Neural mobilisation Myofascial release
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8+yrsClinical experience
1,200+Patients treated
4.9★Google rating
8Techniques available
Techniques integrated at Sevens
Eight hands-on techniques.
One clinical programme.
Joint MobilisationRestricted range of motion, joint stiffness
Grade I–IV
Spinal Manipulation (HVLA)Acute back/neck, facet dysfunction
When indicated
Dry NeedlingTrigger points, chronic muscle overload
Specialist
Myofascial & CuppingFascial restriction, post-training recovery
Soft tissue
Neural MobilisationSciatica, radiculopathy, nerve tension
Neurodynamic
Sports & Therapeutic MassageInjury recovery, muscle tightness
Recovery
Kinesiology TapingJoint support, proprioception, load management
Adjunct
Instrument-Assisted MobilisationScar tissue, tendinopathy, fascial adhesions
IASTM
How We Apply These Techniques

A technique is not
a treatment.
Integration is.

Manual therapy and advanced techniques are not standalone services to be booked like a massage. At Sevens, every technique is selected based on your clinical assessment findings and applied as a precise component of a broader rehabilitation programme.

How techniques are usedStandalone clinicSevens approach
Clinical assessment firstOften skippedEvery new patient
Technique selection rationaleRoutine or preferenceAssessment-driven
Reassessment after techniqueRarely doneEvery session
Exercise follows treatmentNot includedCentral to programme
Evidence grade disclosedNeverDiscussed openly
Progress tracked objectivelyPain rating onlyROM, strength, function
Honest about limitationsRarelyAlways
01
Assess before you treat

Every patient undergoes a clinical assessment before any technique is applied. We identify the specific mechanical, neurological, and tissue-level drivers of your condition — then select techniques accordingly, not habitually.

02
Techniques create a window — exercise fills it

Manual therapy and advanced techniques reduce pain, restore range of motion, and improve tissue extensibility. But those changes are temporary without exercise. We use the window a technique creates to load the tissue correctly before it tightens again.

03
Reassess after every technique

After every manual therapy application, we re-assess range of motion, pain, and movement quality. If the finding has not changed, we change the technique or the approach — not just repeat the same intervention.

04
Honest about what the evidence says

We apply techniques where clinical evidence supports them. Where evidence is moderate, we say so. We do not oversell passive treatments or create indefinite dependency on hands-on sessions.

05
One clinician throughout your treatment

The physiotherapist who assesses you applies your manual therapy. Continuity matters clinically — the subtleties of tissue response, pain behaviour, and mechanical findings require a practitioner who knows your full history.

The Eight Techniques

What each technique does
and when we use it.

Every technique has a specific clinical indication. This is what each one does, what the evidence says, and which conditions it is most appropriate for.

Joint Mobilisation Evidence: Strong

Graded passive movements applied to stiff or hypomobile joints — Maitland Grades I through IV, from oscillatory to end-range stretch. Grade I and II are primarily neurophysiological (pain relief); Grades III and IV target capsular and ligamentous restriction to restore range of motion. Applied at the hip, knee, ankle, shoulder, wrist, and all spinal joints depending on the clinical finding.

Used for Joint stiffness following immobilisation or surgery Cervical and lumbar facet joint restriction Frozen shoulder (adhesive capsulitis) — all stages Hip, knee, and ankle mobility restriction Post-fracture joint stiffness after healing
Spinal Manipulation (HVLA) Evidence: Strong for acute LBP

High-velocity low-amplitude thrust technique applied to a specific spinal segment. Produces an audible cavitation and immediate neurophysiological changes including reduced muscle guarding, pain inhibition, and improved segmental mobility. Applied only after thorough screening for contraindications including vascular risk factors, red flag pathology, and hypermobility. Not used routinely — only when assessment findings confirm a mechanical restriction that meets the clinical threshold for HVLA.

Used for Acute mechanical low back pain with facet loading signs Cervical facet joint restriction with pain and reduced ROM Thoracic stiffness contributing to neck or shoulder pain Acute wry neck (torticollis) in appropriate presentations
Neural Mobilisation (Neurodynamics) Evidence: Strong for radiculopathy

Specific movement-based techniques that restore the normal mobility, extensibility, and gliding of neural tissue within its mechanical interface. Neural tissue that cannot move freely becomes sensitised — producing pain, tingling, numbness, and referred symptoms into the limb. Neurodynamic assessment identifies the specific nerve and the level of neural tension; mobilisation techniques then progressively restore neural mobility from distal to proximal, reducing central sensitisation and radicular symptoms.

Used for Sciatica and lumbar radiculopathy (L4, L5, S1) Cervical radiculopathy with arm pain and paresthesia Carpal tunnel syndrome — median nerve mobilisation Cubital tunnel — ulnar nerve tension reduction Thoracic outlet syndrome
Dry Needling Evidence: Moderate–strong

Fine sterile needles inserted into myofascial trigger points — hyperirritable foci within taut bands of skeletal muscle that refer pain and restrict movement. The needle produces a local twitch response, releasing the trigger point, reducing local and referred pain, and improving the extensibility of the affected muscle. Distinctly different from acupuncture in rationale: dry needling is based on Western anatomical and neurophysiological principles. Applied by physiotherapists with specific post-graduate qualification at Sevens.

Used for Chronic neck and shoulder myofascial pain Headaches of cervical origin (trigger points in suboccipitals) Gluteal and piriformis trigger points in back and hip pain Calf and plantar fascia trigger points Chronic overuse myofascial patterns in athletes
Myofascial Release & Cupping Evidence: Moderate

Myofascial release uses sustained manual pressure and fascial stretching to release restrictions in the myofascial system — the connective tissue web enveloping muscles and joints. Cupping therapy applies negative pressure to lift and decompress fascial layers, increasing local circulation, reducing myofascial adhesion, and improving tissue extensibility. Neither is applied as a relaxation technique — both are clinical interventions with specific mechanical targets identified at assessment.

Used for Fascial restriction following injury or surgery Thoracolumbar fascia restriction in chronic back pain Post-training recovery in athletes with high training loads Plantar fascia restriction in plantar fasciitis IT band and TFL restriction in runners
Sports & Therapeutic Massage Evidence: Strong for muscle pain

Physiotherapist-delivered deep tissue and sports massage targeting the specific muscles and soft tissues identified at assessment. This is clinical massage — not relaxation massage. Techniques include deep transverse friction (for tendon and ligament adhesions), effleurage, petrissage, and muscle energy techniques. Applied to the specific structures driving your presentation — not a full-body routine. Often used immediately before exercise to improve tissue extensibility and reduce guarding before loading.

Used for Muscle tightness and overuse in athletes Deep transverse friction for tendinopathy Post-injury muscle spasm and guarding Scar tissue management — early and late stage Hamstring and calf strain rehabilitation
Kinesiology Taping Evidence: Moderate as adjunct

Elastic therapeutic tape applied to skin using specific directional tensions to achieve mechanical and neurological effects — proprioceptive enhancement, load distribution, mild joint support, oedema management, and cutaneous receptor stimulation that modulates pain signalling. Never applied as a cosmetic or psychological intervention. Tape application technique, direction, tension, and anchoring all differ depending on the clinical goal. We explain the specific mechanism for each taping application so patients understand what it is doing and why.

Used for Patellofemoral pain — patellar tracking correction Post-ankle sprain oedema management and stability support Shoulder impingement — scapular positioning tape Postural correction facilitation — cervical and thoracic Return-to-sport load management during transition
Instrument-Assisted Soft Tissue Mobilisation (IASTM) Evidence: Emerging

Specialised stainless steel instruments used to detect and treat fascial restrictions, scar tissue adhesions, and abnormal tissue texture through a controlled microtrauma response. IASTM stimulates local fibroblast proliferation, disrupts disorganised collagen in scar tissue, and restores normal tissue extensibility in areas inaccessible to manual therapy alone. Applied to specific findings — not a routine soft tissue technique. Used particularly where previous manual therapy has plateaued and tissue quality, rather than joint mechanics, is the limiting factor.

Used for Chronic Achilles tendinopathy with poor tissue quality Post-surgical scar tissue adhesion Patellar tendinopathy — mid-tendon pathology Plantar fasciosis — chronic heel pain Tibialis posterior tendinopathy
Conditions We Treat

Where manual therapy
makes the difference.

These are the presentations where manual therapy and advanced techniques have the strongest clinical evidence and produce consistent, measurable results at Sevens.

Acute & chronic neck painMobilisation + manipulation
Lumbar disc & mechanical back painMobilisation + neural mob
Sciatica & lumbar radiculopathyNeural mobilisation
Cervical radiculopathy & arm painNeural mob + mobilisation
Frozen shoulder (all three phases)Grade III–IV mobilisation
Rotator cuff tendinopathyMassage + IASTM + loading
Headaches of cervical originDry needling + mobilisation
Knee OA & patellofemoral painMobilisation + taping
Achilles & patellar tendinopathyIASTM + loading programme
Plantar fasciitis & heel painMyofascial + IASTM
Ankle sprain & chronic instabilityMobilisation + taping
Post-surgical scar tissueIASTM + myofascial release
Tennis & golfer's elbowDeep friction + IASTM
Carpal tunnel syndromeNeural mobilisation
Thoracic outlet syndromeNeural mob + rib mobilisation
What happens in a manual therapy session A typical 45–60 minute treatment session at Sevens
1
Subjective update (5 min)

Review of changes since last session — pain behaviour, activity levels, response to previous treatment. Identifies whether the clinical approach needs adjusting.

2
Objective reassessment (10 min)

Movement testing, palpation, and neurological screen where relevant. Compares findings to your baseline — tracking whether your measurable deficits are improving.

3
Manual therapy & techniques (20–25 min)

Targeted application of the indicated technique or combination. After each significant intervention, the finding is re-assessed before continuing. If the response is unexpected, the technique is modified immediately.

4
Exercise and loading (10–15 min)

Therapeutic exercise applied while the tissue is in its improved state from manual therapy. This is what converts short-term gains from treatment into durable changes in movement and strength.

5
Home programme update

Any updates to your home exercise programme are confirmed. You leave knowing exactly what to do before your next session and why.

A note on realistic outcomes

Manual therapy reliably reduces pain and restores mobility — often significantly within 2–4 sessions. It does not rebuild strength, correct movement patterns, or prevent recurrence on its own. For lasting results, manual therapy is always paired with a specific rehabilitation exercise programme at Sevens. Patients who complete only the hands-on component without the exercise component have higher recurrence rates — and we are transparent about this from your first session.

Patient Outcomes

What manual therapy
produces in practice.

Representative outcomes from patients treated with manual therapy and advanced techniques at Sevens, integrated with exercise rehabilitation.

Chronic Neck Pain & RadiculopathyMobilisation + neural mob + dry needling — 41yr patient, 8 weeks
MeasureSession 1Session 8
Neck pain (VAS)7.5/101.5/10
Cervical rotation (limited side)32°68° (full range)
Arm tingling / paresthesiaDaily, constantResolved
Headache frequency4–5 per week0–1 per week
Treatment: Maitland mobilisation C5–C6, median nerve mobilisation, suboccipital dry needling
Frozen Shoulder (Frozen Phase)Grade III–IV mobilisation + exercise — 52yr patient, 12 weeks
MeasureSession 1Session 12
Shoulder flexion ROM65°148°
External rotation ROM8°44°
Night pain (disrupting sleep)Every nightResolved
Overhead reach (daily tasks)Severely limitedNear full function
Treatment: Grade III–IV GH mobilisation, posterior capsule stretch, progressive rotator cuff loading
★★★★★
Sciatica & Neural Mobilisation

"I had sciatica running from my lower back into my foot for 11 months. Two surgeons had recommended an operation. Sevens assessed me properly, started neural mobilisation in the first session, and by week 6 the leg pain was completely gone. No surgery. I am back to running. I wish I had found them sooner."

RK
Rahul K.Sciatica · L5 radiculopathy · Indiranagar
★★★★★
Dry Needling & Neck Pain

"I had been getting fortnightly neck massages for 3 years and the relief would last about 4 days. Sevens found the trigger points with dry needling and within 4 sessions the pain had reduced by around 70 percent. They also gave me exercises and now I manage it myself without needing regular treatment."

PM
Priya M.Chronic neck pain · IT professional · Koramangala
★★★★★
IASTM & Achilles Tendinopathy

"Chronic Achilles pain for 18 months. Tried rest, stretching, orthotics — nothing worked for more than a week. The IASTM combined with the loading protocol at Sevens changed the tissue quality completely. Now at 8 months post-treatment I am back to running 40km a week. Total game changer."

AS
Aditya S.Achilles tendinopathy · Runner · HSR Layout
Questions

Everything you need
to know before booking.

Questions from real patients about manual therapy and advanced techniques. A clinician answers when you call or WhatsApp.

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General
Manual therapy is the hands-on component of physiotherapy — a range of techniques including joint mobilisation, spinal manipulation, soft tissue work, and neural mobilisation applied by a qualified physiotherapist to restore normal movement, reduce pain, and improve tissue function. It is appropriate for anyone with musculoskeletal pain, joint restriction, nerve-related symptoms, or movement dysfunction where a mechanical cause has been identified. At Sevens, manual therapy is never applied without a clinical assessment first — we identify the specific structural target before selecting a technique.
No. Massage is one specific soft tissue technique — therapeutic manipulation of muscles and connective tissue. Manual therapy encompasses a much broader range of clinical interventions: joint mobilisation and manipulation, neural mobilisation, instrument-assisted tissue work, and myofascial techniques. These are applied with clinical precision to specific anatomical targets identified at assessment. At Sevens, therapeutic massage is used when it is the most appropriate technique for the clinical finding — not as a default or routine treatment.
A spa massage provides relaxation through generalised soft tissue work — it is not a clinical intervention and does not address specific mechanical dysfunctions. A general physiotherapy clinic may apply manual therapy routinely without a rigorous assessment of what specific structure needs addressing. At Sevens, every technique is selected based on clinical assessment findings — we know the specific joint, nerve, muscle, or fascial layer we are targeting before we begin. We also reassess after every technique application, which most clinics do not do. And we integrate exercise immediately after manual therapy to convert the temporary window of improved mobility into lasting change.
Manual therapy at Sevens is always a finite course with a discharge goal. The purpose of passive hands-on treatment is to reduce pain and restore mobility rapidly enough to enable therapeutic exercise — which addresses the underlying cause of your condition. Patients who attend manual therapy indefinitely without an exercise component are managing a symptom rather than correcting a cause. We are explicit about this from session one: our goal is to make you independent, not dependent on regular treatment to remain comfortable.
No referral is required. Physiotherapists are primary healthcare practitioners and you can book directly. If you have existing scan reports, specialist letters, or previous physiotherapy notes, bring them — they provide useful clinical context. They are not required for your first appointment. The clinical assessment at Sevens is thorough enough to identify the appropriate treatment approach from first principles, regardless of what has been done previously.
For many musculoskeletal conditions, meaningful reduction in pain and improvement in movement is detectable within the first 2–4 sessions. Joint mobilisation and neural mobilisation in particular often produce immediate improvements in range of motion that are measurable at the end of the same session. More complex presentations — frozen shoulder, chronic tendinopathy, post-surgical restrictions — require more sessions before significant change is observed. We set specific, measurable milestones at your assessment so you know what to expect and by when, rather than leaving outcomes vague.
Yes. Manual therapy at Sevens integrates with our physiotherapy, Clinical Pilates, fitness training, and nutrition services. It also coordinates with external treatments — orthopaedic specialist care, sports medicine, pain management, and surgical rehabilitation. If you are receiving corticosteroid injections, undergoing imaging-guided procedures, or following a post-surgical protocol, your physiotherapist at Sevens will work within those parameters and communicate with your specialist team where appropriate.
Techniques
Joint mobilisation uses slow, rhythmic passive movements within or at the limits of joint range — Maitland Grades I through IV. It is comfortable, controlled, and does not produce a cavitation sound. Spinal manipulation (HVLA — high-velocity low-amplitude thrust) applies a rapid, specific thrust to a targeted spinal segment, typically producing a "click" or "crack" from gas cavitation in the joint fluid. Both are effective for different clinical presentations. Mobilisation is appropriate for a wider range of patients. HVLA is indicated for specific mechanical restrictions where assessment confirms appropriate candidacy and contraindications have been screened. We never apply HVLA without explicit explanation and patient consent.
Dry needling and acupuncture use the same type of fine sterile needle, but their rationale is entirely different. Acupuncture is based on traditional Chinese medicine meridian theory and the flow of qi. Dry needling is based on Western anatomical and neurophysiological principles — targeting specific myofascial trigger points (hyperirritable nodules within taut muscle bands) that have been identified clinically. The needle produces a local twitch response, releases the trigger point, and modulates pain signalling through segmental and systemic neurological mechanisms. At Sevens, dry needling is performed only by physiotherapists with post-graduate qualification in the technique.
Neural mobilisation (neurodynamic techniques) restores the normal mechanical behaviour of neural tissue — the ability of nerves to glide, stretch, and move freely within their surrounding mechanical interface (bone, muscle, fascia, and connective tissue). When neural tissue loses this mobility due to injury, adhesion, or increased sensitivity, it produces pain, tingling, numbness, and referred symptoms into the limb. Neurodynamic assessment identifies the specific nerve, the specific level of restriction, and the direction of tension. Mobilisation techniques then progressively restore normal neural mechanics, reducing sensitisation and alleviating symptoms from the distal end of the nerve towards the central nervous system.
IASTM uses specially designed stainless steel tools to scan and treat fascial restrictions, scar tissue adhesions, and areas of abnormal tissue texture that are difficult to address with manual therapy alone. The instruments detect alterations in tissue texture through tactile feedback to the clinician's hand and then apply controlled micro-trauma to the affected area. This stimulates local fibroblast activity, breaks down disorganised collagen in scar tissue, promotes tissue remodelling, and restores extensibility. Applied at Sevens as a targeted intervention based on assessment findings — not a routine soft tissue technique.
The myofascial system is the web of connective tissue enveloping every muscle, organ, and joint in the body. Restrictions in this system — from injury, chronic postural stress, surgical scarring, or repetitive loading — create tension and pain patterns that do not always follow conventional anatomical referral patterns. Myofascial release applies sustained manual pressure and gentle tissue stretching to release these restrictions, restoring normal fascial mobility and reducing mechanical tension across the affected region. At Sevens, myofascial assessment is part of every comprehensive physiotherapy assessment — restrictions are mapped before treatment begins.
There is a psychological component to any treatment, but kinesiology taping has measurable mechanical and neurological effects when applied correctly. The elastic tape stimulates cutaneous mechanoreceptors and proprioceptors, enhancing joint position sense and altering pain signalling through gate control mechanisms. Different application techniques achieve different effects: inhibition taping reduces overactive muscle activity; facilitation taping activates inhibited muscles; decompression taping lifts fascial layers to improve lymphatic flow and reduce oedema; directional taping guides movement patterns. The key is specificity of application — correct tape direction, tension, and anchoring for the specific clinical goal. Applied incorrectly, kinesiology tape achieves nothing clinically useful.
Cupping applies negative pressure to skin using suction cups — either static (stationary placement) or dynamic (cups moved over oiled skin). The suction lifts fascial layers, increases local blood and lymph flow, reduces myofascial adhesion, and improves tissue extensibility. The evidence for cupping is condition-specific — stronger for myofascial pain and post-training recovery, less strong for acute injury management. At Sevens, cupping is indicated when assessment identifies fascial restriction or myofascial adhesion that is limiting movement or causing pain. It is not applied routinely or as a wellness adjunct. The characteristic circular bruising (ecchymosis) is normal and resolves within 5–7 days.
Yes. Our physiotherapists are trained in and apply multiple manual therapy frameworks based on clinical indication: Maitland (graded oscillatory joint mobilisation, highly applicable to spinal and peripheral joints), Mulligan (mobilisation with movement — particularly effective for peripheral joints and some cervical presentations), and McKenzie (directional preference approach for spinal conditions — identifying and applying the specific movement direction that reduces symptoms and centralises pain). No single framework is applied dogmatically — your clinical findings determine which approach is most appropriate.
Maitland's grading system describes the amplitude and position within range of joint mobilisation techniques: Grade I — small amplitude rhythmic oscillation at the beginning of range (primarily for pain relief through neurophysiological mechanisms); Grade II — large amplitude oscillation well within range, not reaching resistance (pain relief and early range restoration); Grade III — large amplitude oscillation up to and into resistance (targeting joint restriction, improving range); Grade IV — small amplitude at end range, into resistance (targeting capsular restriction, restoring end-range mobility). Grade III and IV are the primary grades for restoring joint range of motion. Selection depends on pain levels, the nature of resistance, and the clinical goal.
Yes — and a typical session at Sevens often integrates 2–3 techniques based on clinical findings. For example, a patient with chronic neck pain and radiculopathy might receive cervical mobilisation to restore joint range, followed by median nerve mobilisation to address neural tension, followed by dry needling to release suboccipital trigger points contributing to referred head pain. Each technique targets a different structural component of the same presentation. We reassess between techniques to confirm that each intervention is achieving the expected clinical change before proceeding to the next.
Conditions
Yes — and neural mobilisation in particular has strong clinical evidence for radicular leg pain from lumbar disc herniation. The approach addresses the mechanical component of sciatica by restoring neural mobility and reducing mechanical sensitisation along the sciatic nerve pathway. Combined with directional preference loading (McKenzie approach to identify the movement direction that centralises leg pain), most lumbar radiculopathy presentations respond significantly within 4–8 sessions. Surgery is rarely the first-line recommendation from Sevens for disc-related sciatica without significant neurological deficit.
For cervical radiculopathy without significant progressive neurological deficit (worsening arm weakness, loss of reflexes), physiotherapy including manual therapy is the evidence-supported first-line intervention and should be trialled before surgical referral. For cervical myelopathy (spinal cord compression producing gait disturbance, bilateral hand symptoms, or bladder changes), surgery may be appropriate — and in this case, HVLA manipulation is absolutely contraindicated. Your assessment at Sevens will identify which category your presentation falls into and advise accordingly — including when we believe surgical opinion is appropriate.
Imaging findings in osteoarthritis correlate poorly with pain levels — many patients with severe radiographic OA have mild pain, and vice versa. Manual therapy for OA addresses the mechanical contributors to pain: joint stiffness reducing proprioception and increasing compressive loading, periarticular muscle guarding restricting movement, and neural sensitisation amplifying pain signals. Grade I and II mobilisation combined with progressive muscle strengthening consistently reduces OA pain and improves function — even in advanced radiographic grades. We do not create false expectations about reversing structural OA, but the functional improvements from a combined manual therapy and exercise programme are clinically significant.
For cervicogenic headaches (headaches originating from the cervical spine) and tension-type headaches with significant cervical component, physiotherapy has strong evidence. The C1–C3 spinal segments share neural pathways with the trigeminal nerve (responsible for facial and head pain), meaning dysfunction at the upper cervical spine can directly produce headache. Cervical mobilisation, suboccipital muscle dry needling, and upper cervical manual therapy can produce significant and lasting headache reduction in appropriate presentations. Migraine is a different neurological condition where manual therapy plays a more limited adjunctive role.
Manual therapy plays a supportive but not primary role in tendinopathy management. The primary treatment for tendinopathy is progressive tendon loading (heavy slow resistance training) — this is the intervention with the strongest evidence for tendon structural change and long-term recovery. However, IASTM, therapeutic massage, and myofascial release can improve tissue quality, reduce pain sensitisation, and improve movement mechanics around the affected tendon — creating better conditions for the loading programme to work. At Sevens, manual techniques in tendinopathy are applied as adjuncts to the loading programme, never as a substitute for it.
Yes — and chronic low back pain is one of the most common presentations responding to combined manual therapy and exercise at Sevens. Long-standing back pain typically involves multiple components: joint restriction, myofascial tightness, neural sensitisation, deconditioning, and altered movement patterns. Manual therapy addresses the joint and tissue components; exercise addresses the strength and movement components; and patient education addresses the central sensitisation and fear-avoidance patterns that often maintain chronic pain. Patients with years of chronic back pain frequently report significant improvement within 6–10 sessions when all components are addressed in parallel.
Yes — with specific technique selection based on the surgical procedure, timeline, and surgeon's protocol. Post-joint replacement manual therapy focuses on restoring capsular mobility, reducing periarticular soft tissue restriction, and improving proprioceptive function. Post-spinal surgery manual therapy avoids manipulation of the surgical level but can address adjacent segment stiffness and soft tissue restriction above and below the operated level. We always request surgical notes and surgeon's protocol before applying any technique to a post-surgical patient.
Yes. Thoracic outlet syndrome involves compression or irritation of the brachial plexus and/or subclavian vessels as they pass through the thoracic outlet — between the clavicle and first rib. Manual therapy addresses the specific structural contributors: first rib mobilisation, scalene and pectoralis minor soft tissue release, cervical and thoracic mobilisation, and neurodynamic techniques for the brachial plexus. This is a complex presentation requiring thorough assessment to differentiate neurogenic from vascular TOS and to confirm the specific anatomical contributor before treatment begins.
Sessions
Your first appointment is a 45–60 minute clinical assessment — not a treatment session. It covers your full clinical history, a detailed physical examination (movement testing, palpation, neurological screen where relevant, and specific orthopaedic tests), a review of any existing scan reports or specialist letters, and a clear explanation of your diagnosis in plain language. You leave with a written summary of your assessment findings, an explanation of which techniques are indicated, and a proposed treatment plan. Treatment begins at the second session — the assessment is a clinical process, not a precursor to selling you a package.
This depends on your condition, its duration, and your clinical response. Typical ranges:
  • Acute mechanical back or neck pain: 4–8 sessions
  • Cervical or lumbar radiculopathy (sciatica, arm pain): 6–12 sessions
  • Frozen shoulder: 10–20 sessions over 3–6 months
  • Chronic tendinopathy (Achilles, patellar): 8–16 sessions
  • Post-surgical manual therapy: 6–16 sessions depending on procedure
  • Cervicogenic headache: 6–10 sessions
We provide an honest estimate after your assessment — not a pre-sold package. Session count is driven by your clinical progress.
For acute presentations, twice weekly for the first 2–3 weeks produces faster progress. For chronic or complex presentations, once weekly or fortnightly is typical once the acute phase settles. Frequency is calibrated to your tissue response — attending twice weekly without the tissue having recovered from the previous session is ineffective. Your physiotherapist will advise on the optimal frequency after your assessment and adjust it based on how your condition is responding between sessions.
Some techniques involve a degree of therapeutic discomfort — this is normal and clinically appropriate. Grade III and IV joint mobilisation at end range, deep transverse friction massage, dry needling local twitch response, and IASTM can all produce temporary discomfort during application. Your physiotherapist will explain what to expect before applying any technique, will ask for feedback continuously, and will work within your comfort tolerance. Post-session muscle soreness for 24–48 hours is common after soft tissue work and dry needling — this is a normal tissue response, not an injury.
Comfortable clothing that allows access to the area being treated. For lower back and hip presentations: shorts or loose trousers and a vest or loose t-shirt. For neck and shoulder presentations: a vest, sleeveless top, or shirt with buttons for easy removal of the collar. For knee and ankle presentations: shorts or cropped trousers. We have private assessment and treatment rooms with changing facilities available. You do not need to wear specific exercise clothing unless your session includes a significant exercise component.
Follow the specific post-treatment guidance your physiotherapist gives you — this varies by technique applied. General principles: complete your home exercises as prescribed while the tissue is in its improved state; avoid activities that specifically aggravate the treated area for 24 hours after significant mobilisation or dry needling; drink adequate water after soft tissue work; apply ice if there is any post-treatment inflammatory response. If you experience unexpected significant pain or neurological symptoms following treatment, contact us immediately rather than waiting for your next appointment.
Manual therapy creates a temporary window of improved mobility, reduced pain, and better tissue extensibility. Without exercise during that window, the tissue returns to its previous state before your next session — each treatment starts from zero. The home exercise programme ensures that the gains from each session are reinforced and built upon. Patients who do their home exercises between sessions consistently progress faster, need fewer total sessions, and have lower recurrence rates. We design exercises specifically around what was achieved in each session so they directly extend the clinical benefit.
Safety
When applied by a qualified physiotherapist following thorough contraindication screening, cervical and lumbar HVLA manipulation has a very low serious adverse event rate. Minor side effects — temporary soreness, localised aching — occur in approximately 30–50% of patients and typically resolve within 24 hours. The risk of serious adverse events (vertebrobasilar insufficiency, cauda equina syndrome) is extremely rare — estimated at less than 1 in 500,000 to 1 in 1,000,000 for cervical manipulation by a physiotherapist who has conducted appropriate screening. At Sevens, every patient receives a thorough contraindication screen before HVLA is considered, and the technique is never applied without explicit informed consent and explanation of the expected procedure and sensations.
Contraindications vary by technique. Absolute contraindications to spinal HVLA manipulation include: cervical instability, active fracture, cord compression signs (myelopathy), vascular anomalies in the vertebral artery territory, active infection or inflammatory arthritis in the acute phase, and severe osteoporosis at the treatment level. Dry needling is contraindicated in patients with needle phobia, bleeding disorders, anticoagulant medications, active skin infection at the needle site, and pregnancy (at certain spinal levels). Cupping is contraindicated over open wounds, active dermatitis, varicose veins, and in patients on blood thinners. All of these are screened at your assessment and any technique with a contraindication is simply not applied — an alternative approach is selected instead.
Yes to both. All dry needles used at Sevens are single-use, individually packaged sterile needles — disposed of in a sharps container after each use. They are never reused. Dry needling as a technique has a favourable safety profile when applied by a trained practitioner: the most common adverse events are localised bruising, temporary soreness at the needle site, and mild fatigue. Serious adverse events (pneumothorax from needling over the lung apex, significant bleeding) are extremely rare and are prevented by appropriate anatomical knowledge and technique. At Sevens, dry needling is only applied by physiotherapists with post-graduate qualification in the technique.
Yes — with appropriate technique modifications. Many common complaints during pregnancy (pelvic girdle pain, lower back pain, pubic symphysis dysfunction, rib pain) respond well to physiotherapy and carefully selected manual therapy. Contraindicated approaches during pregnancy include: spinal manipulation of the lumbar spine and sacrum in the third trimester, direct abdominal soft tissue work, and dry needling at certain spinal and abdominal points associated with uterine stimulation. Please inform us of your pregnancy when booking — this ensures the appropriate techniques are selected and the treatment room is configured appropriately.
Seek urgent medical attention before a physiotherapy appointment if you have: bilateral neurological symptoms in both legs or arms simultaneously, loss of bladder or bowel control (indicates potential cauda equina emergency — attend A&E immediately), significant trauma with possible fracture that has not been imaged, unexplained fever, night sweats, or unexplained weight loss alongside your pain (possible systemic cause), pain that is severe at rest and not influenced by position, or a known malignancy. At Sevens, we screen for red flags at every assessment and will refer you appropriately if any are identified. When in doubt, call us before booking — we will advise whether manual therapy is appropriate.
Practical & Booking
The initial assessment is priced separately from follow-up treatment sessions. Sessions are priced individually — there are no compulsory block bookings or packages. Patients integrating manual therapy with Clinical Pilates, fitness training, or nutrition at Sevens are eligible for an integrated programme rate. Current pricing is confirmed when you call or WhatsApp. There are no additional charges for technique combinations — a session applying joint mobilisation, neural mobilisation, and dry needling is the same price as a session applying a single technique.
Most comprehensive health insurance plans in India cover physiotherapy including manual therapy under outpatient physiotherapy benefits — particularly when associated with an injury, post-surgical rehabilitation, or a chronic musculoskeletal condition. Coverage varies significantly by insurer and policy. We provide detailed clinical documentation, itemised receipts, and a clinical letter to support your insurance claim. If your insurer requires a pre-authorisation letter or referral from a specialist, we can provide a clinical summary letter to facilitate this. Check with your insurer before your first appointment.
Book via the form on this page, by calling +91 98765 43210, or by WhatsApp. We respond within 2 working hours. Assessment appointments are typically available within 2–4 working days, with same-week appointments usually available. Bring any relevant medical documentation: MRI or X-ray reports, specialist letters, surgical notes if applicable, and a list of current medications. Comfortable clothing appropriate to the area being treated. Please mention at booking if you have a specific contraindication (bleeding disorder, anticoagulant medication, pregnancy) so we can confirm which techniques are appropriate for your first session.
Yes — and for most presentations, the combination of manual therapy with exercise rehabilitation at Sevens produces better outcomes than either alone. Manual therapy restores the movement and reduces the pain that enables therapeutic exercise. Exercise then rebuilds the strength and motor control that prevents recurrence. Where Clinical Pilates is indicated, manual therapy at the start of the programme restores the range of motion needed for effective Pilates exercises. Where fitness training is the goal, manual therapy addresses any residual restrictions before progressive loading begins. All services at Sevens share clinical notes — your programme is coordinated, not fragmented.
Patients travel to Sevens from Koramangala, BTM Layout, Jayanagar, Indiranagar, JP Nagar, Whitefield, and elsewhere in Bangalore. For complex presentations — chronic radiculopathy, frozen shoulder, cervicogenic headache, post-surgical rehabilitation — the quality of clinical assessment and technique specificity is worth the travel, particularly in the early stages when the clinical approach is being established. Once the acute phase is managed and you have a home exercise programme, session frequency typically reduces. We can also advise on home management strategies between sessions to make less frequent visits clinically effective.
Book Your Assessment

Your pain has
a source.
Let us find it.

Book a 45–60 minute clinical assessment. You leave with a clear diagnosis, an explanation of which specific structures are driving your pain, a proposed treatment plan with realistic timelines, and interim guidance to act on before your first treatment session.

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Assessment before any treatment 8 techniques available Technique + exercise integrated HSR Layout, Bangalore No GP referral needed Same-week appointments
Request a Callback We respond within 2 working hours. Mention you are booking for Manual Therapy.
No GP referral needed · Assessment first · Treatment from session 2