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General Orthopedics


Orthopedics is a medical specialty that works to address dysfunction within the musculoskeletal system. It focuses on the diagnosis, correction, prevention, and treatment of disorders of the bones, joints, muscles, ligaments, tendons, nerves, and skin that make up the musculoskeletal system.

A general orthopedic physical therapist has a whole-body approach, which helps make connections between orthopedic conditions in various parts of the body. Patient's conditions may have developed over time, from an injury, or from surgery. Specialized orthopedic treatment can allow the patient to regain their range of motion, strength, endurance and control through guided exercises and manual treatments.

A comprehensive orthopedic evaluation will allow for an accurate diagnosis to both treat the current problem and help prevent future injuries to the musculoskeletal system.

Common diagnoses treated include:

  • muscle sprains and strains
  • joint pain (arthritis)
  • neck and back pain
  • Tendinitis
  • Torn ligaments
  • Recovery following fracture
  • Post-surgical care

Manual Therapy


Manual therapy includes joint, nerve and soft tissue mobilization with the therapist's hands, or in some cases, instruments. Manual therapy can increase range of motion, reduce or eliminate soft tissue inflammation, improve tissue repair, facilitate movement, and decrease pain.  Any specific technique, or combination of techniques of manual therapy may fit your treatment plan.   


Trigger Point Dry Needling


Physical therapists use dry needling to treat myofascial pain, which is a disorder in which pressure on sensitive points in the muscles causes pain in seemingly unrelated body parts. Myofascial pain often happens after a muscle is overused, or if you have a repeated injury. The technique uses a “dry” needle, one that has no medication or injection in it. The needle is inserted through the skin into areas of the muscle, which are called trigger points.

  • A trigger point is a band of skeletal muscle located within a larger muscle group. Trigger points can be tender to touch. Touching a trigger point may cause pain to other parts of the body.
  • Dry needling uses a thin, solid filament needle to penetrate the skin and stimulate trigger points in the muscles. Using the needle, a physical therapist targets tissues that they cannot treat as easily manually. It is typically one technique that’s part of a larger treatment plan.

Dry needling can give longer lasting relief than massage. The needles do not hurt going in because they are very fine and solid. The needles only stay in long enough to relax the muscle. The amount of needles you will need, or sessions of dry needling, depends largely on the amount of pain you have, and the amount of areas you need work done on. You may feel slightly sore after dry needling, but within a period of a few hours to a day, you will feel less pain and tightness in the muscles, and you’ll notice improvement in chronic injuries.

Goals of Dry Needling

The goal of dry needling is to release or inactivate trigger points to relieve pain or improve range of motion. Dry needling improves pain control, reduces muscle tension, and normalizes dysfunctions of the motor end plates, the sites at which nerve impulses are transmitted to muscles. This can help speed up the patient’s return to active rehabilitation.

Dry needling is typically used for these purposes:

  • Give you lasting pain relief
  • Eliminate muscle tension, wherever you hold it
  • Heal overuse injuries
  • Remove “knots” in muscles
  • Help muscles heal after injury
  • Speed healing time
  • Improve blood flow
  • Stimulate a muscle to work better
  • Prevent injuries before they happen
  • Help patients resume exercising
  • Heal chronic injuries of muscles, tendons and joints

Spine Rehabilitation


80% of Americans experience back or neck pain at some point in their lives. A truly effective spine rehabilitation program will first identify the exact cause(s) of the pain; and then will correct the source of the problem by incorporating a combination of successful techniques including manual therapy techniques; movement re-education for the spine, hip and abdominal muscles; strengthening; and functional flexibility.

 Home exercises are a critical component for addressing back or neck pain, but best results are often had by starting with the manual techniques that will quickly reduce the acute pain and facilitate movement and exercise tolerance.




Headaches can be classified into different types including cluster, tension-type, cranial neuralgia, facial pain, and migraine. Cluster and tension-type headaches are treated by decreasing the painful trigger points in the head, neck, and postural muscles, improving the mobility of the vertebrae and soft tissue in your neck and upper back, strengthening your postural muscles, and increasing your flexibility.

“Sitting is the new smoking” means that Americans frequently spend increased hours staring at computers or mobile devices with devastating effects on their overall health and quality of life. Prolonged sitting contributes to forward head posture and therefore, poor blood flow to our postural musculature.  The combination of manual therapy techniques and specific exercise to improve posture and endurance of the postural muscle systems, can decrease the pressure on the joints, muscles and nerves that cause headaches.


Post Concussion Syndrome and Whiplash


A concussion is another term for a traumatic brain injury that occurs following a blow to the head.  Concussed patients can have persistent symptoms such as headaches, difficulty concentrating, dizziness, irritability, and brain fatigue. These symptoms can last for months after injury. Specific manual therapy techniques and strengthening of the upper part of the neck may help reduce or eliminate symptoms.

Whiplash is similar in that it can include symptoms of a concussion (brain bruise or injury) along with sequelae of spinal injuries in the neck.  Evaluating all of the contributing factors is critical to full and functional recovery following any whiplash injury.


Nasal Specific Release


Used to treat concussion, headaches, whiplash, and many other spinal conditions, Nasal Release Technique is a powerful structural technique that adjusts the bones of the skull. It was developed by Dr. J. R. Stober of Portland. The procedure uses a small finger cot affixed to an inflatable device which is inserted into the nasal passages.

The balloon inflation presses outward against the bones lining the breathing passages and adjusts the sutures of the skull, particularly the sphenoid. This ultimately relieves the forces that have gone into the skull by releasing any impactions in the cranial sutures.  

Click here for more background and to view a video demonstration. 

Indications and conditions treated

• Concussion and other head injuries
• Headaches, head pressure, migraines
• Low energy, Fibromyalgia, chronic fatigue
• Muscle spasms, neck and shoulder pain
• Poor concentration and focus
• Sinusitis, sleep apnea, snoring, other breathing and sinus disorders
• Tinnitus (ringing in the ears)
• Traumatic Brain Injury
• TMJ (mouth, head and jaw pains)
• Vertigo and other balance problems
• Whiplash Syndrome


Post-surgical Rehabilitation


Physical therapy is a key component of surgical recovery.  Working with a physical therapist after an operation will decrease your post-surgical pain, restore normal movement in your joints and muscles, build strength to return to normal activities more quickly, and reduce the risk of reinjury.  The key is to work with a therapist who keeps your individual needs and goals in mind; every patient is different and responds to surgery differently.