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Manual Therapy

Hands on Techniques

Manual Therapy is a broad term used to refer to skilled, hands on techniques applied to treat soft tissue, connective tissue (fascia) and joints to reduce pain, improve movement patterns, decrease swelling or inflammation, decrease muscle tone in a shortened overworked muscle group and help facilitate pain free movement. 

Depending on the therapist’s background there will be different names that describe the type of manual therapy one uses in practice. 

Jay has been trained in many of these modalities and utilizes some form for manual therapy in all treatment plans.

Soft Tissue/Fascia Techniques:

Joint Techniques:

Manual Therapy - Hands on Techniques

Facia is a densely woven system of connective tissue that envelopes every muscle, bone, nerve, blood vessel and the internal organs in one continuous structure from head to toe. It has a similar appearance to a spiders web or a knitted sweater. Facia is full of nerve endings, stretch receptors and pain receptors which send messages back to the brain communicating the health, pliability and movement quality of the tissues.  Facia is involved one way or another in all musculoskeletal pain. It is a really good idea to have techniques that work on this system.

Reason we can have restrictions in the fascial system:

  • Trauma (both physical, mental and emotional) 
  • Scars (both from trauma and surgery)
  • Chronic muscular tension
  • Repetitive movements and repetitive strain 
  • Decreased movement patterns due to fear of moving a particular way
  • Lack of varied movement throughout the day. (ie sitting too much!)

So what happens in the fascial system that leads to problems?

  • thickens and no longer is pliable which leads poor movement patterns
  • thickening decreases blood and fluid from flowing freely through the tissue – old fluid and blood (which carries oxygen) stay lodged in the tissue longer not allowing for fresh nourishment to get to that part of the body
  • Decreased range of motion
  • Decrease the ability for a nerve or blood vessels the lengthen fully
  • swelling/ inflammation 

Myofascial Release and Structural Integration are systems of techniques that assist in ‘unwinding’ this dense tissue by communicating with the receptors in the fascia via the skin (the largest organ in the body). These techniques lead to increase circulation (blood flow = healing), increased range of motion and decreased perceived tension in a particular part of the body. This work can also lead to correcting postural imbalances that contribute to, or are a result of pain and injury.

The process of cupping involves the placement of specialized cups strategically on areas of the skin to create a suction that lifts the skin up into the cup thus increasing the surface area between the skin, fascia and muscle layers under the cup(s). During the process, different layers of tissues get separated which can trigger tearing and micro-trauma. In response to this micro-trauma, the body begins to create new blood vessels, which is called neovascularization.

With these newly formed blood vessels comes the release of platelets, white blood cells and the increase of oxygen to promote healing. When numerous cups are placed on the back or around an injured area, it can start to stretch the connective tissues together with fascia for improved movement.

Benefits of cupping therapy, include:

  • Chronic pain relief
  • Promoting blood circulation
  • Relieving emotional stress
  • Reducing swelling
  • Loosening tight muscles


Here’s how cupping therapy can help you to get rid of old as well as new injuries:

  • Increasing tissue delivery and oxygenation, increasing circulation
  • Triggering micro-trauma and helpful inflammation
  • Eliminating old stagnant blood
  • Stretching connective tissue and fascia
  • Developing new blood vessels

Scars form as part of the body’s natural healing process, when a dense, fibrous type of tissue forms to close wounds and repair damage following an injury, which can include unexpected traumatic injuries like motor vehicle accidents or falls, but surgical scars are the most common I see in practice. This includes both from recent and old surgeries.

Why this can be an problem:

When most people think of scars, they think of just what appears on your skin. But that scar tissue winds deeper throughout the body occurring on fascia, muscles, tendons and ligaments. Because scar tissue is thicker and stiffer than normal tissue and it can bind up numerous layers of muscle and connective tissue which leads to restricted range of motion, decrease in flexibility, and decrease muscle contraction in the area where the scar develops. This can lead to chronic pain and/or instability in the body.

Scars can be mobilized in a numerous techniques: 

  • specialized scar needling
  • Instrument Assisted Soft Tissue Mobilization 
  • Cross friction and myofascial massage techniques 

Instrument assisted soft tissue mobilization, or more commonly known as IASTM, is the use of tools to assess tissue quality and to treat areas identified to have scar tissue, soft tissue restrictions, chronic inflammation or degeneration. The tools are used to gently scrap the skin providing micro trauma to the area being treated. The introduction of controlled microtrauma to the affected soft tissue structures causes the stimulation of a local inflammatory response.

This response initiates reabsorption of inappropriate fibrosis or excessive scar tissue and facilitates a cascade of healing activities resulting in remodeling of affected soft tissue structures. Adhesions within the soft tissue which may have developed as a result of surgery, immobilization, repeated strain or other mechanisms, are broken down allowing full functional restoration to occur.