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Manual Therapy

All the Evolution physical therapists incorporate manual therapy techniques into our treatment sessions.  Manual therapy may be useful to improve joint or soft tissue mobility, to reduce pain caused by a disruption in the transfer of forces through a joint, along a muscle or other soft tissue. Our therapists have received post-graduate training in the specific manual therapy techniques described below:

Visceral Manipulation

Visceral Manipulation is a technique developed by French osteopath and physical therapist Jean-Pierre Barral. This approach involves applying a gentle stimulus to the fascia and ligaments of the pelvic, abdominal and thoracic organs to reinstate mobility within the visceral (organ) and musculoskeletal (muscle and bone) systems. While all body systems (including our organs) require movement to maintain optimal health, after injury any tissue can lose mobility due to the normal inflammatory process.  Injury to the organ system, such as infection, direct trauma, or  abdominal surgery, and history of chronic illness such as irritable bowel syndrome or dysmenorrhea can result in decreased organ mobility, leading to chronic organ related pain.  In addition, a decrease in organ mobility may be overlooked as an underlying driver in musculoskeletal pain due to fascial links between the organ and musculoskeletal systems.   Visceral manipulation can complement a more traditional physical therapy intervention with the goal of treating the whole person.  Evolution physical therapists Alison Aiken, Michelle Downing, and Meagen Satinsky are all trained in visceral manipulation.

Functional Manual Therapy

Functional Manual Therapy (FMT), developed by Gregg and Vicky Johnson of the Institute of Physical Art, is a manual therapy system which looks at the whole person through evaluating mechanical restrictions of joints and soft tissues, neuromuscular capacity, and movement patterns to find both the root cause of injury as well as work towards the goal of improved health and well-being.  Seen through the FMT paradigm, the body does not consist of individual areas which work independently of one another, but muscles and joints which work in an interdependent way to create mobility and stability.  While pain may be felt in one area of the body, there may be contributing factors from soft tissue or joint restrictions, poor muscular engagement or faulty movement patterns which contribute to symptoms.  Treatments using the FMT approach involve the application of manual therapy to joints, muscles, fascia and nerves during active movements with the goal of improving function.  Muscular engagement is enhanced through the use of Proprioceptive Neuromuscular  Facilitation (PNF), a hands-on exercise technique developed to enhance the body’s own inherent strength and stability. In order to prevent the return of symptoms, attention is also paid to the modification of daily activities such as sitting, sleeping, standing and a comprehensive home exercise program is prescribed.  Physical therapist Dr. Michelle Downing is a certified functional manual therapist (CFMT)

Craniosacral Therapy

Craniosacral therapy, developed by William Sutherland, is a manual therapy that has its roots in Cranial Osteopathy. After studying with Sutherland in the 1970’s, Dr John Upledger developed Upledger CranioSacral Therapy (CST), utilizing a subtle touch to detect and release restrictions in the craniosacral system to improve the functioning of the central nervous system.

The craniosacral system consists of the brain and spinal cord which are enveloped in cerebrospinal fluid that’s produced within the system, as well as a membrane called the dura mater. This system has a rhythm, similar in idea to that of an arterial pulse. The rhythm is a reflection of the movement of the cerebrospinal fluid within the dura mater and intracranial membranes that line the skull. Since the CranioSacral system is connected to your bones, muscles, and organs through fascial networks, a CranioSacral therapist can detect the rhythm anywhere in the body. The rhythm’s quality at different locations in the body helps to recognize and treat problems throughout the body by means of subtle touch.

The dura mater is attached at one end to the cranial bones and at the other end to the sacrum. This design allows the cranium and sacrum to be used as a sort of steering device in order to perform subtle manipulations of the bones to release relevant restrictions in the dura mater and surrounding membranes. This approach is practiced worldwide and is effective for a wide range of medical challenges associated with pain and dysfunction including migraines, chronic neck and back pain, concussions and traumatic brain injuries, chronic fatigue, stress and tension related problems, TMJ, PTSD, post-surgical dysfunction. Physical therapist Meagen Satinsky is trained in Cranial Sacral Therapy.