Therapy begins with evaluating the whole body for restrictive patterns and compensations and discerning the source of the issue.
No two patients are alike. Each individual is treated according to his or her restrictive tissue presentation.
Treatment consists of an integration of multiple manual therapy techniques to release restricted areas, thereby restoring the mobility of the structures, fluid circulation, and neural communication, leading to improved physical functioning.
What are modalities? Modalities, in physical therapy, are the various techniques used to produce a physiologic response or change to help patients achieve their therapy goals.
Visceral Manipulation
Developed by Jean-Pierre Barral, DO, RPT. Visceral Manipulation is a gentle manual therapy that focuses on releasing connective tissue restrictions in and around the internal organs and compensatory body patterns.
This treatment helps to restore the mobility of the organs and improve the cellular environment and physiologic function. It also frees up the mobility of associated joints and tissues and improves postural alignment.
Examples of conditions that benefit from visceral manipulation are esophageal reflux, hiatal hernia, gallbladder dysfunction, constipation, post-surgical adhesions, and spinal dysfunctions.
Neural Manipulation
Developed by Jean-Pierre Barral, DO, RPT, and Alain Croibier, DO. Neural Manipulation assesses the mobility of nerves and releases specific areas of restrictions along the nerve, its outer sheath, and its inner connective tissue components.
This approach evaluates and treats the peripheral nerves including the cranial nerves, and the dural membranes of the brain and spinal cord. The effect of this treatment is to allow nerves to stretch and move more freely through tissue along their path, and to improve the health of the nerve and its conductivity.
Some examples of conditions that benefit from this approach are carpal tunnel syndrome, nerve impingement/pain syndromes, headaches, concussions, whiplash injuries, neck pain, sciatica, and digestive issues.
Visceral Vascular Manipulation
Developed by Jean-Pierre Barral, DO, RPT and Alain Croibier, DO.
This approach gently releases restrictions along the arteries to improve their mobility through tissues, especially the internal organs and improve blood flow and physiology of the organ or tissue area that it supplies.
Cranial and Brain Techniques
An integrative approach with treatment concepts from Bruno Chikly, MD, Jean-Pierre Barral, DO, RPT, John Upledger, DO, Tad Wanveer, MT, and Paul Chauffeur, DO.
Treatment focuses on releasing restrictions and strain patterns within the cranium and spinal cord, releasing tension within the cranial bones, sutures, and membranes, the brain nuclei and pathways, and improving fluid circulation and health of the brain and spinal cord.
This approach is effective for conditions such as concussions, whiplash, headaches/migraines, temporomandibular dysfunction, cranial neuralgias, torticollis, and spinal mobility restrictions.
Lymphatic Drainage Therapy
An approach developed by Bruno Chikly, MD.
A gentle rhythmic hands-on therapy that improves lymph circulation, helps free up areas of congestion/swelling in the tissues, optimizes fluid homeostasis, and enhances the immune system function and the body’s healing process.
Myofascial Release
Following the curriculum developed by John Barnes, PT, and fascial research by Serge Paoletti, DO.
This approach releases restrictions to improve connective tissue/fascial mobility. Fascia is connective tissue that surrounds every cell in the body and is interconnected like a woven sweater. The fascia that is associated with muscles is called myofascial, and this connective tissue surrounds every fiber of the muscle, and it is the ligaments and tendons, and membranes throughout the body.
When restriction or tension develops in an area, the tissue cannot elongate and function fully and affects surrounding interconnected structures. Myofascial restrictions alter the function of muscles and joints, create postural imbalances, and may cause pain or sensation changes.
Muscle Energy Technique
Muscle Energy Techniques/Manual Medicine studied through Philip Greenman, DO at Michigan State, releases motion restrictions to improve the biomechanics of the spinal joints and extremity joints.
This involves specifically positioning a restricted joint and having the patient actively contract a muscle followed by a relaxation. It is a gentle method to manipulate restricted joints.
Muscle Recruitment Retraining,
Functional Exercise Training, Postural Re-Education
Studied from multiple sources including Mark Bookhout, PT, Vladimir Janda, MD, Shirley Sahrmann, PT, Gary Gray PT, Barbara Headley, PT.
For a deeper understanding of some of the techniques discussed above, here are links to authoritative sources:
Brain techniques – Bruno Chikly, MD – Chikly Health Institute
Visceral manipulation, nerve manipulation – Jean-Pierre Barral, DO, RPT – Barral Institute
Craniosacral therapy – John Upleger, DO – Upleger Institute