What We Treat

Problems associated with the spine can range from localized neck, back, or sacral area pain, to pain radiating into the head, arms, trunk, pelvic floor, or legs. Local pain problems of the spine are frequently generated by local dysfunction created by soft tissue strains resulting in poor mobility and malalignment of joints. Radiating symptoms (pain, numbness, tingling, burning...) and/or weakness may occur as a result of nerve tissues being irritated and/or compressed. We will separate the spine into the following sections:

Neck: injury to the cervical spine may result in localized neck pain, head and/or facial pain, and/or radiating symptoms to the arms (pain, numbness, tingling, and/or weakness). Severe spinal injuries of the neck affecting the spinal cord may result in symptoms to the rest of the body. Upper cervical spine dysf. has an increased chance of impacting the body d/t to its proximity to the brain/brain stem. With this in mind, we commonly treat the neck (if indicated) in effort to treat other problems in the body. Our objective with most treatments to the neck is to normalize the soft tissues and restore alignment and mobility to the cervical vertebrae, thereby reduce pain, optimize space for nerve tissues, and improve mobility and function.

Thorax:  The thorax refers to the area of the thoracic spine (mid - upper back) and ribs. Pain problems in this region are not uncommon. Soft tissue strains in the region commonly contribute to malalignment and hypomobility of the spine and/or ribs. Because it is an area containing a density of autonomic nerves (nerves responsible for automatic function of the body such as the function of organs), dysfunctions in this area commonly impact problems related to stress, organs, and systemic problems. The lungs, heart, diaphragm, stomach, liver, kidneys, and other organs are in the region and may be impacted. Problems in the thoracic area are frequently complex and challenging.

Low back and sacroiliac: This is another common problem area which often involves poor alignment of the lumbar spine and/or sacroiliac joints. Correcting alignment is part of the key, but normalizing the tone of soft tissues is also necessary as significant asymmetries of tone are likely to pull the joints out of alignment again. Manual treatment, core strengthening, movement control/retraining, and self correction techniques are all typically part of the program. Taping techniques may be used to help control movement and prevent reinjury of further aggravation of the problem. Involvement of the discs of the lumbar spine are quite common and this can create its own unique set of challenges. The treatment previously outlined holds true for this also, however further intervention is indicated to work to centralize the disc and alleviate pressure on nerve tissues (if indicated). Modalities such as traction may be utilized, and exercises that are directionally specific often help. We will also help you learn to move in a way that minimizes the impact on the affected area to keep you from aggravating the problem and allow for healing. A fully ruptured disc or severely degenerated spine can be quite problematic and surgery may be indicated, however, we will do our best to help your body heal with conservative treatment.


The hip joint: Hip pain may be generated from the low back, sacroiliac joint, soft tissues around the joint and/or the joint itself. Pain localized to the hip and/or groin often indicates an arthritic joint. With an arthritic joint, we can often help reduce your symptoms, however you may continue to experience some level of pain or discomfort. In some cases a hip replacement surgery may be indicated. We can help sort it out and either get it better or get you on your way to the help that you need.

The knee: Knee pain is quite common. Strains of the meniscus and other soft tissues of the knee may be the extent of the problem, however, meniscus tears are not uncommon and may need further intervention (i.e. injections or surgery). Arthritic knee joints are also fairly common and we can often help reduce pain by treating the soft tissues around the joint and improving alignment. The hip, foot and ankle often play a significant role in alignment of the knee. We will examine all of it and treat what we find.

Other extremity problems: While we have addressed some of the more common problems, problems of the elbow, hand, ankle, and foot are also treated with the same methodology: restore proper tone of the soft tissues in the area, address contributing dysfunction of the central nervous system (head and spine), other tissues (i.e. nerves in the arms or legs), and restore proper alignment of the joints. Exercises to assist with mobilizing and or strengthening the area are generally part of the care plan. While it may sound simple, the body is complex, and it is often a complex process that takes time and a lot of work. Again, we are up for the challenge!

The Shoulder: The shoulder is a complex joint that involves four articulations which allow for more mobility than any other joint in the body. Increased mobility results in decreased stability making the shoulder more prone to injury. These injuries are most commonly associated with impingement and tears of the rotator cuff. Soft tissue strains create imbalance of the force coupling of the rotator cuff muscles that keep the joint centered, and dysfunction of the neck and upper back commonly contribute to the problem. Pain is typically felt in the lateral part of the shoulder and/or upper arm when reaching the arm up or back. Treatment is focused on restoring proper mechanics of the joint by normalizing the soft tissues, restoring proper mobility of the associated joints, and strengthening of the rotator cuff and back muscles. Shoulder impingement is often a complex and challenging problem. We are up for the challenge!"

The Elbow: Tennis elbow (lateral epicondylitis) is likely the most common elbow problem we see. It is felt as pain in the lateral part of the elbow and is most commonly a result of overuse of the arm, but may be a result of an injury (i.e. with racquet sports such as Tennis). Golfer's elbow (medial epicondylitis) is felt on the inside of the elbow, and is more commonly a golfing injury. Both involve muscles and tissues of the forearm. The neck and upper back will be evaluated for possible contribution.

The Hand: Trigger fingers, tendonitis, and arthritic joints make up the bulk of hand problems we see. The neck is commonly involved and will be assessed and treated as appropriate. Hand problems may require splinting or bracing. Hand therapy may be indicated for custom splinting.

The hip: Hip pain may be generated from the low back, sacroiliac joint, soft tissues around the joint and/or the joint itself. Pain localized to the hip and/or groin may indicate an arthritic joint. However, arthritis may not be the source of your pain. We will work to identify and address all associated problems. With a severely arthritic joint, we can generally help reduce your symptoms, however you may continue to experience some level of pain or discomfort. In some cases a hip replacement surgery may be indicated. Whatever the case may be, we can help sort it out and either get it better or get you on your way to the help that you need.

The knee: Strains and/or tears of the ligaments and cartilage/meniscus of the knee commonly create knee pain and instability and problems. Other soft tissues around the knee, leg muscle tension, or weakness may also cause or contribute. Significant tears of the meniscus and ligaments are not uncommon and may require surgery. Arthritic knee joints are also fairly common and we can often help reduce pain by treating the soft tissues around the joint, strengthening leg muscles, and improving knee joint alignment. However, a knee replacement surgery may be indicated for severely arthritic joints. The hip, foot and ankle play a significant role in alignment of the knee, and low back problems can also contribute. We will examine all of these and treat the associated dysfunctions.

The Foot and Ankle: Sprains and strains are common in the ankle and foot and typically create localized pain problems. However, these problems may significantly impact the body by affecting gait and alignment of the knees and hips resulting in more problems. Flexible flat feet resulting in a flattening of the arch of the foot with weight bearing is a common example that can have a significant impact on the ankle, knee, and hip. Asymmetries or "limping" may impact the spine and result in low back pain or other problems up the chain. Orthotics to support the arch, manual treatment to address soft tissue strains and joint restrictions, and exercises to address tightness and/or weakness are generally implemented.

Other problems: While we have addressed some of the more common problems, other problems are often treated with the same methodology: restore proper tone and function of the soft tissues in the area, address contributing dysfunction of the central nervous system (the head and spine) and other tissues (i.e. nerves, vascular tissues, fascia, and/or muscles), and restore proper alignment and mobility of the joints. Exercises to assist with mobilizing and/or strengthening are generally part of the care plan. While it may sound simple, the body is complex, and it is often a complex process that takes time and a lot of work. Again, we are up for the challenge!

Treatment of pain problems is our specialty. The hands-on, comprehensive approach of Counterstrain is highly effective in addressing pain problems of many kinds in a relatively painless manner. Combined with other manual therapies, therapeutic exercises, and modalities (see "Our Services"), we can help in reducing, managing, or eliminating most pain problems.

We commonly treat pain problems throughout the body. If you have many problem areas, you may have what we call a centralized problem - meaning that some or much of your pain is generated by the central nervous system (brain and/or spine). This is a more complex problem, but we can help with that too. We enjoy working with complex problems!

Most pain problems of the head can be improved by treating the head itself and/or the spine. Problems with the neck (especially the upper part of the neck) and sacrum, often contribute to headaches. Also, it is worth noting that significant dysfunction of the head can have a significant impact throughout the body. We will commonly address cranial dysfunction when treating many different pain problems in the body. We can help you get your head on straight (literally) and get rid of the headaches!

Balance is the ability to maintain your body over its base of support (your feet) and relies on a complex set of sensorimotor control systems that include your vision, information received from muscles and joints (proprioception), and vestibular organs in the inner ear. Information from these sources is processed by your brain (specifically the Cerebellum) and messages are sent out to the body to help you maintain balance. When any of these components are compromised, balance problems (in addition to other problems such as vertigo and nausea) may occur.

We will assess to determine which components are impaired and focus treatment to the appropriate areas. Inner ear problems commonly present with vertigo and nausea and are generally effectively treated by repositioning the vestibular organs (otherwise known as canalith repositioning). Other balance problems require exercises and use of an assistive device (i.e. cane) may be indicated to prevent falls. We can help determine the most appropriate interventions to keep you on your feet.

To be sure, motor vehicle accidents can really put the body in disarray. The combination of high forces and limited ability for the body to prepare for and withstand these forces can result in significant injury. Many of these injuries are directly related to soft tissue strain as strains often occur from movement that the body is not prepared for and/or overloading the tissues.

We specialize in treating soft tissue strains with the Counterstrain technique. We will also work to realign joints throughout the body that may have been torqued out of place and/or may be held out of place by tight, strained tissues. Let us help you undo the impact of your accident and get you back on the road to feeling better!

We treat a wide variety of neurological problems from localized neuralgias (often described as numbness, tingling, burning, or shooting pains), radiculopathies (typically stemming from the spine and felt into the arms or legs), to brain injury and stroke. Treatment will vary from manual treatment to alleviate symptoms to focusing on motor control and relearning tasks (ie. gait training) after a stroke.

(Hip or knee replacement, spine surgery, shoulder surgery...)

Physical therapy is indicated to optimize the outcome of many orthopedic and neurological surgeries. This is especially true of joint replacement surgeries. We believe that to have the best possible outcome, physical therapy should start prior to your surgery in most cases. By doing so, we can better prepare you and your body for the trauma of surgery. This is done by educating you on what you need to do to be prepared (i.e. what exercises should you be doing, what assistive devices and/or adaptive equipment will you need, how to get up and down stairs safely, etc.). We will also work to prepare your body by normalizing soft tissues (to the extent possible) around the surgical area. This will allow for better blood flow, decreased swelling, better and faster healing, and decreased risk of complications (i.e. infection, blood clots and abnormal swelling).

Post operative treatment generally addresses the same problems, but will focus more on restoring mobility, strength, and functional ability. Let us help you to be prepared and with your recovery process to ensure a successful surgery!