Relieving Musculoskeletal Problems Through

Manual Physical Therapy

The Myokinesthetic System

The Myokinesthetic (My-o-kin-es-thet-ic) System is a very effective hands on physical therapy technique for relief for pain, lost range of motion and other health-related issues, involving muscle, soft tissue and nerves.

The goal of the Myokinesthetic System is to identify and then address the cause of the problem within the nervous system. It is then possible to stimulate and “reset” the nervous system to correct the problem.

We believe a person’s posture is an outward representation of their nervous system. Postural abnormalities are thus a dysfunction in the nervous system. Through a detailed postural assessment of the upper and lower body, the physical therapist identifies the nerve root which is causing the problem for that person. The nerve root that is identified is the primary lesion and could have been injured/stressed long ago. For example: A whiplash trauma to the neck from a fall results in a stiff neck that resolves in 3-4 days with nonmedical conservative care. A few days, weeks or even years later you wake up with a stiff low back with no incident. “It must have been how I slept.” The low back pain has now gone un-resolved or worsens and is unresponsive to conservative management. Our findings often indicate the neck pain resolved due to a lower body compensation. That compensation or others now involved is causing the low back pain. Treatment to the neck is indicated to resolve the compensatory pattern you are stuck in.

Compensations occur throughout the musculoskeletal system to protect us from this initial injury resulting in pain distant from this area. This pain often occurs without injury and is mostly unresponsive to conservative management.

It is not uncommon for LB pain to be caused from an initial neck injury or visa versa. This system allows us to focus our treatment sessions on the causative factor and getting you long term relief.

The Myokinesthetic System is deceptively simple and yet capable of generating profound modifications in the body’s nervous system. By stimulating all the muscles along a specific nerve root, the nervous system learns to send the proper signal to the muscles to allow them to respond and function normally. The result is postural correction leading to improved range of motion with reduced tension and pain and abnormal sensations such as “pins and needles”, numbness or burning.

Positive response with long term carryover is obtained in 4-5 physical therapy sessions for problems of less than 2 years and in 8-12 sessions for problems over 2 years. To obtain these results, it is crucial to have 3-4 physical therapy sessions in the first week of treatment and then the frequency of sessions is reduced.

Instrument Assisted Soft Tissue Mobilization/IASTM

IASTM is a hands-on physical therapy technique using specific tools to detect and treat soft tissue and fascial restrictions and post-operative scars. The use of tools to mobilize these tissues encourages tissue remodeling and tissue regeneration, improved local circulation and lymph drainage. The result is the release and breakdown of fascial restrictions and scar tissue adhesions. Range of motion gains are seen in the surrounding joint and treatment muscles to allow for improved function and pain reduction. IASTM is used in combination with therapeutic exercise and flexibility training to encourage further tissue mobilization for long term carryover of the physical therapy treatment session.

Myofascial Release

Myofascial Release is a safe and very effective hands-on physical therapy technique that involves applying gentle sustained pressure into connective tissue restrictions to eliminate pain and restore motion. Physical therapy treatment involving myofascial release is affecting the patient at the soft tissue and at the cellular level. This allows for profound changes in the treatment area and along the tissue pathway. Its effects are immediate and long lasting resulting in improved musculoskeletal function and aiding postural correction.

Fascia is a connective tissue that surrounds every muscle, muscle fiber and organ. It also aids in the make up our cellular structure. Fascia forms a continuous web coursing from head to toe as it envelopes structures of the nervous, circulatory and musculoskeletal system. An example of fascia is the dense, silvery strip seen coursing through a beef tenderloin or the dense shiny film covering a chicken breast. Fascia can become restricted due to injury, chronic inflammation, disuse or failure to move through a given range of motion for prolonged periods. Fascial restrictions in muscles often form trigger points, like contracted knots, that cause pain and tightness and can refer pain away from its origin.

Muscle Energy Techniques

Muscle Energy Technique (MET) is a hands-on physical therapy technique which uses a muscle’s own energy in the form of gentle isometric contractions to relax the muscles via the nervous system to gently lengthen the muscle. It is muscle that moves bone and the nervous system that controls the muscle. MET is sending information to your brain to correct bony asymmetries in the extremities and the spinal column through the normalization of muscle tone. The result is a pain free technique that improves joint mechanics reducing pain and increasing joint function. This non-manipulative physical therapy technique is very gentle yet powerful in correcting spinal and pelvic restriction leading to neck, low back and sacroiliac pain.

The Hesch Method

The Hesch Method is a systematic physical therapy technique to address lumbopelvic hip dysfunction. The physical therapist utilizes spring testing to the pelvis, hips and sacrum to identify joint restrictions effecting movement and producing functional limitation and pain. Low load long duration stretching is applied addressing the ligamentous and large muscles of this area producing long term changes to the bony alignment. Joint mechanics in the hips, sacrum and pelvis improves which normalizes the base for the lumbar spine aiding resolution of LB pain. This physical therapy technique is highly effective in correcting SI dysfunction and leg length differences. We have found clinically, that the treatment to the sacrum is critical in the resolution of mid thoracic pain, TMJ and headaches in the female population due to ascending reflexive holding patterns.

Low load long duration stretching is also utilized to mobilize joints in lower leg and upper extremity providing improved mechanics and relieving joint pain without utilizing manipulative/thrust like techniques that can cause injury and post treatment pain.

Organ Specific Fascial Mobilization/Visceral Manipulation

Organ Specific Fascial Mobilization (OSFM) is a hands-on physical therapy technique provided by an experienced therapist using his or her hands to move and release fascial restrictions in your abdomen and pelvis to encourage the normal movement and function of your internal organs. Long term chronic pain that is un-resolving with traditional techniques often has a visceral or organ component to it. Pain patterns that are specific to one side of the body are highly responsive to these techniques. For example: low back pain, thoracic pain, shoulder pain and headache all on the same side are highly organ based. R sided pain indicates liver hypomobility and left side pain indicting stomach involvement. OSFM is also indicated for the patient that has responded to physical therapy but has plateaued at 80-90% improvement. The last 10% improvement is often hindered by a fascial restriction from the viscera.

Diastasis recti clinically responds to OSFM and can improve core strength and aesthetically reduce a protruded, abdomen with very low tone.

Therapeutic Exercise

Physical therapy prescribed exercise programs are created to aid in treatment carryover, improve joint symmetry, flexibility, strength and balance. Individualized home exercise prescription is given in written or electronic form for easy completion at home and is often modified and advanced based on symptom reduction.

Our physical therapists understand today’s busy lifestyle, so programs are streamlined and are often comprised of only 2-4 exercises. This allows for greater compliance and improved functional outcomes.


Active Therapeutic Movements or ATM’s are pain free movements performed on the ATM-2. The ATM-2 is an upright, functional exercise unit that utilizes belts and straps to provide posture correction and compression which improves neurological control of the prescribed movement. Painful motions become pain free as the brain relearns the appropriate muscle firing pattern. The implementation of repeated pain free isometric muscle contractions results in pain free movement and correction of compensatory movement strategies. ATM’s can be completed on the neck, thorax, low back and hips.

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