The Bespoken Word

The Various Manual Therapies offered at Bespoke Treatments


Most physical therapists use a variety of manual therapies depending on the goal of treatment, patient pain level and their day-to-day presentation. Manual therapy can include any interventions the therapist performs on the patient while the patient is passive. Below you can learn a little about different manual therapy approaches used by therapists at Bespoke Treatments.

Article by Doctor of Physical Therapy Emily Lesinksi 


This technique is applied to increase soft tissue mobility by using suction. Cups are applied to the skin and negative pressure is generated inside the cup, thereby lifting the tissues. While it has been a widely-used practice in eastern medicine for centuries, recent studies have shown that cupping causes vasodilation, drawing freshly oxygenated blood to the area, and tissue separation, increasing the ability of skin, fascia and muscle to slide and glide more easily. It is particularly effective in areas of chronic myofascial adhesion. Depending on the extent of the tissue dysfunction, cupping does cause a characteristic circular red mark where local vasculature is affected.


Graston technique is a instrument assisted form of mobilization or IASTM which is performed at Bespoke Treatments in order to improve soft tissue extensibility, increase blood flow/circulation, mobility and range of motion. “Graston Technique enables clinicians to effectively address scar tissue, fascial restrictions and range of motion through comprehensive training, resulting in improved patient outcomes.” 

Soft Tissue Mobilization (STM)

Often thought of as “massage,” this technique involves the therapist using hands-on approaches to manipulate the soft tissues (muscle, fascia, other connective tissues). This may be skin-to-skin, and the therapist may or may not use an emollient on the skin to reduce friction. Therapists may be trained in different specific applications such as myofascial release, trigger point release, rolfing, petrissage or others and often use more than one in a session. STM is meant to increase tissue mobility by mechanical forces generated by the therapist.

Joint Mobilization

Joint mobilization is the movement of joint surfaces relative to each other via hands-on techniques. The patient remains passive while the therapist applies pressure to the joint, or a point just adjacent to it, with the intention of increasing extensibility of the ligaments, joint capsule, and other connective tissues that support the joint. This intervention is applied to areas of the body presenting with limited range of motion where the culprit may not be only muscle tension. When this technique is applied with a high-velocity thrusting motion it is called a “joint manipulation,” what chiropractors call an “adjustment”.

“All manual techniques are effective for modulating pain and temporarily increasing tissue extensibility, mobility, and range of motion. When paired with therapeutic exercise, postural training, gait training and selected other approaches, it is an integral part of a treatment plan.”