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of Some Techniques Used in Rehabilitation

(from Activator Technique to Zero Balancing)


Please note that this is only a partial list of the myriad techniques that exist and in no way represents an endorsement of any technique by Yes! PT. Keep in mind that most of the proponents of these techniques think their approach is the best thing since sliced bread. Since all practitioners are dealing with the same body systems, successful outcomes are still largely related to the accuracy of the diagnosis, the patient’s values and expectations, and the skill of the practitioner.



It is interesting to note the overlap, similarities and differences between the various approaches. Any reference to the parable of the blind men and the elephant is entirely coincidental. . .We should not blame the practitioners, however. In most cases they are providing an honest effort. At present, our understanding of the body’s myriad systems and their myriad interactions is simply incomplete, leaving practitioners to rely on scant evidence. In such a situation it is human nature to grasp any victory against the unknown as a total triumph, instead of seeing it as a coalescing of many factors, the exact relations of some or most of which remain to be discovered.



Certain techniques, which are usually considered to be safe, may carry additional risk for particular patients. For example, dry needling, Graston technique, Rolfing, IASTM and thrust techniques may cause bleeding if you have increased clotting time due to hemophilia or blood-thinning medication (Coumadin, Eliquis, aspirin). Before deciding on a particular approach, Yes! PT encourages you to check for evidence of efficacy and safety of the approach from Google Scholar or Medline Plus. Before starting any new healthcare approach, you should always consult your physician or other qualified healthcare professional.


Selected Techniques

1. Activator Technique

Activator Technique is a method of chiropractic treatment which substitutes impact from a spring-loaded “activator” for the traditional thrust manipulation. It was originated by a chiropractor, Arlan Fuhr, DC. http://www.activator.com

See Also: Thrust Techniques

2. Active Release

Active Release is a technique for functional lengthening of muscles and fascia which purports to be faster and safer than mechanical stretching. It was originated by a chiropractor, P. Michael Leahy, DC.

See Also: Muscle Energy, Strain-Counterstrain

3. Thrust Techniques

Thrust Techniques, also known as High Velocity Low Amplitude (HVLA) techniques or manipulation, are a method of treating joint dysfunctions by applying a brief impulse of force to the joint. The techniques probably originated in ancient Asia, and were transferred to the West through the Bonesetters of old England. Osteopaths, Chiropractors and Medical Doctors who use manipulation were all influenced by the Bonesetters, although each profession developed more or less independently. Many physical therapists learned these techniques largely from a British physician, James Cyriax, MD, known as the “father of Orthopaedic Medicine”, although the modern techniques have been continuously modified to improve patient safety and efficacy. http://www.ifompt.org/

See Also: AAOMPT; Activator Technique (above)

4. Cranio-Sacral Technique

Cranio-Sacral technique is a method of assessing and treating using palpation of body rhythms and gentle corrective intention. It was developed by an osteopathic physician, William Sutherland, DO.

He and subsequent practitioners developed a system of hand placements called “holds” designed to allow them to appreciate the craniosacral rhythm in various places, but primarily on the skull.  The treatment is based on assuring that the craniosacral rhythm is strong and symmetrical, and is accomplished by gently influencing the rhythm with mild manual pressures.  To my knowledge, no study has found that the craniosacral rhythm is a reliable measure.  Regardless of the theory, many people find gentle bilateral cranial pressure to be relaxing.

Modern interpretations of this method are provided by John Upledger, DO through the Upledger Institute, http://upledger.com/ and the Biodynamic Craniosacral Therapy Association of North America. https://www.craniosacraltherapy.org/

For further info: https://www.medicalnewstoday.com/articles/318490

See Also: Zero Balancing (below)

5. Dry Needling

Dry Needling is a method of relieving muscle “knots” by inserting a thin needle into the target muscle at the site of the “knot”. It is sometimes confused with the Chinese technique of Acupuncture, but is a distinct modality, not directly derived from Chinese medicine. This technique was developed by a physician, Janet Travell, MD. In this area, it is most closely associated with a physical therapist, Jan Dommerholt, PT, DPT, MPS. http://myopainseminars.com/ However, it is becoming increasingly popular. https://drjohnrusin.com/dry-needling-physical-therapy/

6. Graston Technique

Graston technique is a method of applying various steel instruments to the skin, sometimes forcefully, to stimulate the body’s repair mechanisms. It was originally developed by a machinist, but is now most-commonly associated with chiropractic care. See Graston Technique. 

7. IASTM Instrument-Assisted Soft Tissue Mobilization is similar to the Graston technique, but uses a different set of instruments and generally lower forces. Its origins are traced to ancient Chinese medicine, but its modern proponents are physical therapists. http://iastmtechnique.com

8. Manual Physical Therapy

Manual Physical Therapy is a broad term, that may include application of many of the techniques described here, and may include others. In general, manual therapists draw from an eclectic background and tend to understand the body as a combination of complementary systems, each presenting the opportunity for improvement through manual contact. See for example: http://www.instituteofphysicalart.com/  and https://swodeam.com

9. Myofascial Release

Myofascial release is a system of diagnosis and treatment based on finding and easing restrictions in the myofascial envelope that surrounds the internal organs and muscles. It was originally developed as an Osteopathic technique, but is now most closely-associated with a physical therapist, John Barnes, PT. http://myofascialrelease.com

See Also: Rolfing

10. Movement System Impairment

Movement System Impairment is a system of physical diagnosis and treatment based on recognition of patterns of movement limitation and pain. Treatments are based on changing muscle activation and movement. It was developed by a physical therapist, Shirley Sahrmann, PT, PhD. Movement System Impairment See Also: Feldenkrais Method, Alexander Technique; Gray Cook, PT – Functional Movement Systems, The McGill Method to fix back pain, Total Motion Release

 The following techniques mostly concern themselves with pain modulation, using different approaches:

11. Myokinesthetic technique

Myokinesthetic technique is a method of diagnosis and treatment that focuses on the contribution of spinal nerve roots to dysfunction. Treatment employs positioning, muscle contraction and soft tissue mobilization. It was developed by a chiropractor, Michael Uriarte, DC. http://www.myokinesthetic.com/

12. Muscle Energy

Muscle energy is a method of evaluation and treatment that involves positioning and isometric muscle contraction to decrease pain and restore function. It was developed by an osteopathic physician, Fred Mitchell, DO. http://www.com.msu.edu/CME/Manual_Medicine_Courses/Muscle_Energy.htm

See Also: Proprioceptive Neuromuscular Facilitation (PNF); Active Release (above)

13. Strain/Counterstrain

Strain/Counterstrain is a method of evaluating and treating using a map of body “tender points” located by palpation and treated by maintaining a static position for a certain time, usually 90 seconds. It was developed by an osteopathic physician, Lawrence Jones, DO. The modern interpretation of this method is provided by Randall Kusunose, PT, and osteopaths and physical therapists from the Jones Institute. https://www.jicounterstrain.com

14. Fascial Counterstrain

Based on the work of Lawrence Jones, DO. This extension of his method by one of his students, Brian Tuckey, PT,OCS, incorporates Brian’s training in visceral manipulation and other manual techniques.  Brian tries to provide a rationale for the appearance of tenderpoints in non-muscular tissue by implicating a range of sensory receptors and neural systems in the production of symptoms.  Fascial counterstrain incorporates soft tissue and visceral techniques along with Dr. Jones’ “position of ease” treatment concept.  As a result, faster treatments (less than 90 seconds) and a broader clinical utility are claimed. https://www.counterstrain.com

15. Functional Technique

Functional technique (FT) is also based on the osteopathic “position of ease” concept, but FT adds the tool of “unwinding” energy stored in a joint.  There are basically 2 approaches: active operator and passive operator.  The active operator applies biomechanical and physiologic knowledge to guide the unwinding process, using compression, traction, mobilization, induced motion, etc.  The passive operator assumes that the patient’s body will know the best way to “unwind” the joint’s stored energy, and so takes a more passive role, allowing the patient to move as required, while ensuring patient safety,  The whole process can take as little as 30 seconds or more than 2 minutes.  There are few set rules regarding functional technique other than initial positioning.  It mostly depends on the interaction between therapist and patient.

This website may have more info: https://musculoskeletalkey.com/functional-technique/

16. Pain Neutralization Technique

PNT is a method of evaluating and treating using areas of tenderness located by palpation and treated by maintaining a gentle passive pressure at a remote location. It was developed by Stephen Kaufman, a chriopractor.

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