Successful Orthopedic Healing Through Functional Manual Therapy

by Amy Stein, DPT, BCB-PMD

This week we had our amazing Corey Silbert, DPT, CFMT and Ryanne Glasper, DPT both present and demonstrate how effective their training in Functional Manual Therapy is, and how quickly one sees results with any orthopedic injury/dysfunction. For example, how a mechanical dysfunction from an ankle sprain can effect the pelvis and neck. How IBS/bowel issues can effect TMJ and vice versa. With this training, results can be seen quickly, even if a patient has been going to PT.

The training and certification that Corey, Ryanne and all the PTs at Beyond Basics Physical Therapy has is through an institution called Institute of Physical Arts. It is a series of courses incorporating an integration of various manual therapy techniques, Alexander technique, Feldenkrais Movement, Pilates, PNF (proprioceptive neuromuscular facilitation) and more. Corey, who is already certified in the training and Ryanne is very close to her certification wrote more about it below.

-4 -2


Introduction to FMT                        Grand Rounds October 7, 2015
Ryanne Glasper, PT, DPT
Corey Silbert, PT, DPT, OCS, CFMT
Amy Stein, PT, DPT, BCB-PMDWhat Is FMT?

FMT, or Functional Manual Therapy, is a manual therapy approach developed by the founders of The Institute of Physical Art (IPA), Gregg and Vicky Johnson.  The FMT approach “couples mechanical treatment of joints, soft tissues, visceral and neurovascular systems with manual neuromuscular facilitation to enhance motor control and function”.  (Johnson, Johnson)  FMT is strongly rooted in PNF or Proprioceptive Neuromuscular Facilitation – and uses PNF principals to facilitate efficient motion and “unlock every patients potential” (M.Knott)

3 core components are assessed and treated:

•    Mechanical dysfunctions: joint and soft tissue restrictions (i.e. Are there enough players to play the baseball game?)

•    Neuromuscular facilitation: ability to initiate the right muscles at the right time with proper strength and endurance (i.e. Do they know how to play the game? How to play their position?)

•    Motor control: the ability to effectively and consistently produce coordinated postural and movement strategies? (i.e. Are they working as a team? Communicating? If not, lots of practice is needed for the individual players to become a successful team.)

How is the FMT approach different?
FMT’s focus is on FUNCTION. Clinicians utilize functional mobilizations, functional movement patterns, and functional tests to diagnose and treat dysfunction.

•    Functional Mobilizations (FM): involves active involvement of the patient to assist in mobilizing joint/soft tissue restrictions (i.e. contract/relax)

•    Functional Movement Patterns (FMP): involves active/functional movements to trace, isolate and treat joint/soft tissue restrictions

•    Functional Tests: Developed by The Johnsons and utilized to determine presence or absence of components contributing to “Automatic Core Engagement (ACE) or “core first” responses, as well as feeling through the system to determine how the entire kinetic chain is functioning as a unit.  Does the individual have a coordinated and efficient use of core muscles to stabilize the trunk with correct timing, efficient strength, endurance required for task.
•    Vertical Compression Test (VCT)-Assessing the affect of gravity on the alignment of the body as a unit
•    Lumbar Protective Mechanism (LPM) –Is there a core first strategy, is there initiation? Strength? And endurance?
•    Elbow Flexion Test (EFT)- assessing alignment of the shoulder girdle, core first strategy of the RTC and the core muscles, vertical alignment of the shoulder girdle on the rib cage and entire body postural alignment

How can FMT benefit Pelvic Health patients?

•    INCLUSIVE: physical therapy interventions, specifically manual therapy techniques, are often so specific that they do not consider the concomitant dysfunctions in related structures (sacroiliac joint, hips, etc.) that may be contributing to overall PF dysfunction.

•    Implications of restoring efficient movement patterns by utilizing PNF techniques for patient success and to “refresh” the HOMUNCULUS!

•    FUNCTIONAL: emphasis on treating the driver not the symptom – based on assessment of function and restoration of function, not just elimination of symptoms.

(Information cited from IPA course work and website)

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s