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1-677-124-44227 184 Main Collins Street, West Victoria 8007 Mon - Sat 8.00 - 18.00, Sunday CLOSED
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Manual Therapy Services


Orthopedic Manual Physical Therapy (OMPT) therapy is an advanced level of physical therapy training that includes skilled, specific hands-on techniques to diagnose soft tissues and joint structures, guiding both passive and active treatments. Expected outcomes may include reducing pain, improving joint mobility, increasing range of motion, reducing soft tissue tension, eliminating joint inflammation, improving joint stability, promoting proper recruitment of muscle groups, restoring normal movement patterns, improving general fitness and returning to work/sport/activity.

Do you want to hear more about Manual Therapy? — Click here.

Our practice of physical therapy concentrates on:


Think of soft tissue mobilization as a medical massage. The purpose is not for a relaxing spa treatment, but to address pain and limitations in your soft tissues. Different types of approaches may be used to relax muscles in spasm, improve mobility of fascia, increase the range you can lengthen your nerves without symptoms and move more fluidly. There are many different names medical practitioners use for the types of soft tissue approaches but they are generally trying to have four basic influences:

  1. Influence tissue mobility (flexibility, posture, range of motion,
  2. Influence the nervous system (reduce pain, resolve muscle spasm, reduce spasm of blood vessels to improve circulation, improve muscle activation)
  3. Influence the vascular system (reduce inflammation, reduce edema in a limb, lymphatic drainage)


Effective soft tissue work is about not finding the latest or greatest technique or practitioner, but about connecting the type of technique that resolves your problem. This is what manual therapy training is all about – using the right tool for the right job.


Joints are the foundation of all movement-they are the hinges that give us mobility. If they are not moving well, it doesn’t matter if our muscles are strong or not. Manual therapy training involves testing each joint for normal motion, and if abnormal, what is causing the restriction. Treatment techniques involve oscillation or stretching the joints for a specific purpose. The impact of joint mobilization includes: reducing pain, lubricating cartilage in joints, reducing muscle spasm, and increasing range of motion. When joints move normally, they send signals to the brain to help with muscle activation for coordination, strength and balance. A joint can also be pain-free but stiff. This stiffness will reduce these signals to the brain, thus reducing muscle activation and causing weakness, loss of coordination and/or loss of balance. Perfecting these manual skills takes time and practice — just the type of advanced training that MTI specializes in.


Joint manipulation is an advanced level of training in manual therapy that involves a short, quick, safe and pain free motion to a joint. Sometimes these movements result in a pop or click in the joint. Manipulation techniques are a foundational skill for OMPT trained physical therapists, physicians, osteopaths or chiropractors. The benefits of these techniques can be similar to what is described above in the joint mobilization section, but they are more intense. You might think about this as comparing an ice pack that is cool versus one that is really cold. The really cold pack will be more intense and therefore more effective at reducing pain. Manipulation techniques are like a really cold ice pack, more intense and sometimes more effective than mobilization techniques. They are not always necessary, but when they are indicated, they can be very effective. Your physical therapist can help you address any concerns you may have over the use  of these techniques, or they can simply not use them on you and stay with more gentle mobilization techniques. The comfort and safety of our patients always comes first.

Physical therapists can legally perform spinal manipulation in almost every state after graduating from physical therapy school. Washington state requires additional proof of postgraduate training in spinal manipulation to obtain a special license endorsement for spinal manipulation. Training for this endorsement is just one of the many specialties we teach at MTI Physical therapy, both for our physical therapists and even for those working at other companies that elect to study with us.


Your pharmacist wouldn’t just give you a random bottle of pills and send you home. The medication would be specific to what you need it for. There would be a specific dosage. You would be instructed when and how to take it. You would be educated on side effects to look out for and in the end, and you would have an improvement in your condition. Therapeutic exercise requires the same approach. You need to be given the right exercises, be properly trained on how to do them, know when you are doing them incorrectly or doing too much, know what to look for if the results are not what you expect and see the results you want.

Therapeutic exercise is very different from the general exercise you have done in an exercise class or associated with participating in a sport. Click here to learn more about what can be accomplished through movement. Movement training for pathology requires a very different level of skill than performing exercises off the internet, following some drawing given to you or working with a personal trainer. As a medical intervention, therapeutic exercise is attempting to resolve abnormal impairments so you can safely return to regular exercise and activity, so it requires the proper dosage and instruction. Your physical therapist will design, dose and supervise your therapeutic exercise program to match your tissue injury and/or movement dysfunction. Our specialized training and equipment allow for early rehabilitation of the most acute injuries progressing to strengthening and enhancing performance.

We believe physical therapy should be delivered by a physical therapist. All our therapeutic exercise is prescribed and performed with the help of a licensed and highly trained physical therapist. MTI Physical therapy does not employ trainers, assistants or aides to deliver any of our high-value care. Contact us at our Bellevue, Kirkland, Issaquah, Magnolia, Fremont, First Hill or Downtown Seattle, WA clinic to schedule an appointment and experience the MTI difference for yourself.


Education is a big part of our care. Sometimes the smallest piece of information can have the greatest outcome. The more you know, the better the outcome. Knowing how pain works is a foundational starting point. Your physical therapist will educate you on how to best manage your problem during and after physical therapy; including self-care strategies, home exercises and work ergonomics. We can also advise you, and when necessary, your trainer on how to best reach all your fitness goals.


If you come to see a physical therapist at MTI Physical Therapy with acute or chronic joint pain, then you can first expect to be thoroughly evaluated during an initial examination. We’ll be assessing and evaluating everything from your range of motion, strength, coordination, pain level, posture, and even relative tissue tension in order to devise an accurate diagnosis.

Based on our exam findings, as well as the information we learn from questioning you about your current and past medical history, we’ll be able to devise a customized treatment plan to meet your unique needs.

Since joint mobilization techniques have been shown to be effective for a variety of conditions, we very well may decide to implement this type of manual therapy in your plan of care.

To prepare for a physical therapy session with joint mobilization at MTI Physical Therapy, be sure to wear comfortable and loose-fitting clothing. Your therapist will need to be able to see or at least easily palpate (feel) the specific joint he or she is mobilizing (keeping in mind of course, that your privacy, safety and comfort are of utmost concern to our staff).

Your physical therapist will also be sure to offer you clear details on how to sit or lie during the session, what you should expect to feel, as well as what to do following your session in order to maximize the effects and prevent recurring pain or dysfunction.

To complement and optimize the effects of joint mobilizations, we’ll also instruct you on additional services, which may include therapeutic exercises for strengthening and range of motion, other modalities that can help in your recovery process, and postural and neuromuscular retraining.

Schedule your manual therapy session today.