Specialized Manual Techniques

Manual and manipulative therapists are Registered Physiotherapists who have completed advanced training in spinal and peripheral joint manipulations and manual therapy. They have been examined by the Orthopedic Division of physiotherapy and are members of Canadian Academy of Manipulative Physiotherapists. These physiotherapists use their hands to assess and treat with joint manipulation or mobilization in various orthopedic conditions. The goals of this treatment are to relieve pain and restore normal joint mobility and function.

There are many techniques and services that our therapists are trained and qualified to perform, and that fall under their scope of practice as a licensed practitioner with their respective governing Colleges that may not be listed on our website.

If you should have a particular question about a treatment techniques kindly contact our clinic. Our admin staff will be able to assist you with your requests and inquiries.


What is Acupuncture?

Acupuncture is one of the oldest, most commonly used medical procedures in the world. Acupuncture is used to encourage natural healing, reduce and relieve pain, and improve function of affected areas of the body. It is a safe and effective, and is often successfully used as an alternative to medications or even surgery.

Acupuncture involves the insertion of very fine needles through the skin and tissues, stimulating specific points on the body. There is NO injection of any substance and the treatment itself causes minimal discomfort. Acupuncture stimulates the body to produce “endorphins”, which are the body’s own pain relieving chemicals. Though it has been used for thousands of years in China, it has only been in recent years that the medical communities in Europe and North America have begun to study acupuncture and understand its effectiveness.

“Classical Acupuncture” was developed in China as a system of diagnosing and treating pain. As part of Traditional Chinese Medicine, acupuncture aims to balance energy and blood in the body in order to keep it functional and healthy.

Anatomical” Acupuncture refers to a more modern approach taken by western trained therapists, including the Acupuncture Foundation of Canada Institute (AFCI). When combined with knowledge of anatomy, physiology and pathophysiology modern therapists can use acupuncture effectively.

Acupuncture is very effective in treating a variety of painful disorders, both acute and chronic. It is a therapeutic method used to encourage natural healing, reduce or relieve pain and improve function of affected areas of the body.

Please refer to: for more information.

CranioSacral Therapy

CranioSacral Therapy is a gentle, hands-on method of evaluating and enhancing the functioning of a physiological body system called the craniosacral system - comprised of the membranes and cerebrospinal fluid that surround and protect the brain and spinal cord.

Using a soft touch generally no greater than 5 grams, or about the weight of a nickel, practitioners release restrictions in the craniosacral system to improve the functioning of the central nervous system.

By complementing the body's natural healing processes, CST is increasingly used as a preventive health measure for its ability to bolster resistance to disease, and is effective for a wide range of medical problems associated with pain and dysfunction, including:

  • Migraine Headaches 
  • Chronic Neck and Back Pain 
  • Central Nervous System Disorders 
  • Orthopedic Problems 
  • Traumatic Brain and Spinal Cord Injuries 
  • Scoliosis  
  • Chronic Fatigue 
  • Emotional Difficulties 
  • Stress and Tension-Related Problems 
  • Fibromyalgia and other Connective-Tissue Disorders 
  • Temporomandibular Joint Syndrome (TMJ) 
  • Neurovascular or Immune Disorders 
  • Post-Traumatic Stress Disorder 
  • Post-Surgical Dysfunction

Quoted from: The Upledger Institute

For more information go to

Graston Technique®

The Graston Technique® incorporates a patented form of instrument-assisted soft tissue mobilization. By gliding the instruments over certain parts of the body it allows the therapist to effectively detect and treat scar tissue and restrictions that affect normal function. This technique significantly activates mast cells and fibroblasts to both replicate and synthesize, helping initiate and speed up the healing cascade for dense connective tissues like tendons and ligaments.

This technique helps by:

  • Separating and breaking down collagen cross-links, and splays and stretches connective tissue and muscle fibers
  • Increasing skin temperature
  • Facilitating reflex changes in the chronic muscle holding pattern
  • Altering spinal reflux activity (facilitated segment)
  • Increasing the rate and amount of blood flow to and from the area
  • Increasing cellular activity in the region, including fibroblasts and mast cells
  • Increasing histamine response secondary to mast cell activity

Quoted from :


Intramuscular Stimulation otherwise known as (IMS) is a total system for the diagnosis and treatment of myofascial pain syndromes (chronic pain conditions that occur in the musculoskeletal system when there is no obvious sign of injury or inflammation). IMS is grounded in Western Medical Science, and has a solid foundation in its radiculopathic model of pain, which is now supported by many experts in the field. The treatment, which utilizes acupuncture needles because they are the thinnest implements available that are designed to penetrate deep within muscle tissue, specifically targets injured muscles that have contracted and become shortened from distress. 

The treatment involves dry needling of affected areas of the body without injecting any substance.  The needle sites can be at the epicenter of taut, tender muscle bands, or they can be near the spine where the nerve root may have become irritated and supersensitive.  Penetration of a normal muscle is painless; however, a shortened, supersensitive muscle will ‘grasp’ the needle in what can be described as a cramping sensation. The result is threefold. One, a stretch receptor in the muscle is stimulated, producing a reflex relaxation (lengthening).  Two, the needle also causes a small injury that draws blood to the area, initiating the natural healing process.  Three, the treatment creates an electrical potential in the muscle to make the nerve function normally again.  The needle used in IMS, by stimulating muscle spindles, essentially becomes a specific and unique tool for the diagnosis of Neuropathic Muscle Pain.

The goal of treatment is to release muscle shortening, which presses on and irritates the nerve. Supersensitive areas can be desensitized, and the persistent pull of shortened muscles can be released.

Quoted from: iSTOP: The Institute for the Study and Treatment of Pain.
For more information go to

Lymphatic Drainage

Lymph Drainage Technique  is a very specialized technique focusing on treatment of swelling and lymphadema in the body. The proper functioning of the lymphatic system is critical to our body’s ability to detoxify and regenerate tissues. The lymphatic system filters out toxins and foreign substances, recovers crucial substances that have escaped from the blood and helps maintain a healthy immune system. Unlike the circulatory system, which uses the pumping action of the heart to circulate the blood, the lymphatic system relies upon hundreds of tiny muscular units called lymphangions to contract throughout the body to propel the lymph. The lymph can then eliminate waste products. When the action of these tiny muscular units is hindered, this can lead to the stagnation of lymphatic circulation. If the lymph circulation stagnates due to injury or infection, toxins accumulate and cellular metabolism is significantly compromised. The result is an increase in acid and toxins within the tissues causing pain, tension, and edema. These substances along with the edema need to be removed quickly from the interstitial fluid in order to promote proper tissue healing and restore proper pain-free movement. 

The lymph drainage procedure involves the practitioner using flat hands and all the fingers to simulate specific wave-like movements. These subtle manual maneuvers activate lymph and interstitial fluid circulation as well as stimulate the functioning of the immune and parasympathetic nervous systems. With lymph drainage, there is immediate and marked reduction of acute and chronic edema and hematomas, post-injury and after surgery. 

Lymphatic Drainage is very effective for the following conditions;

  • Reduction in edema (swelling) and lymphadema
  • Detoxification of the body
  • Regeneration of tissue, including burns and wounds
  • Relief of numerous chronic and subacute inflammations
  • Relief of chronic pain
  • Reduction in the symptoms of chronic fatigue syndrome
  • Reduction in the symptoms of fibromyalgia
  • Relieves muscle spasm
  • Deep relaxation to aid insomnia, stress and loss of vitality
  • Headaches
  • Sports Injuries

  • Whiplash

  • Orthopedic Problems
  • Stroke and head injuries

Quoted from: Therapeutic Systems Inc.

For more info go to

Myofascial Release

Myofascial release is a safe and effective form of soft tissue therapy. It is a technique that involves applying gentle sustained pressure and stretching out certain areas of the body until the release is felt. This motion is followed in the direction of the restriction from one barrier to the next. The goal is to remove these restrictions and restore the body’s equilibrium and balance against gravity. This allows the body to self correct, reduce or eliminate pain, and restores optimum function.

Osteopathic Techniques

Osteopathy addresses the underlying cause of pain and can facilitate and encourage the body to heal itself. Treatment involves gentle manipulation of the hard or soft tissues and joints needing specific osteopathic correction.

Manual Osteopathy is based on four principles:
1. Each structure n the body supports the body’s functions. If a structure is damaged, out of place, or otherwise not working properly, the body will not function at its best.
2. The natural flow of the body’s fluids, lymphatic, vascular and neurological – must be preserved and maintained.
3. The human body is the sum of its parts - Its physical, emotional, social, spiritual, and cognitive systems don’t work independently – they work in harmony.
4. When the body has no restrictions, it has the inherent ability to heal itself.

People that may benefit from Osteopathic treatment are adolescents and children of all ages, athletes, pregnant women, accident victims, people with chronic illness who have not responded to other therapies, adults with repetitive strain injuries and seniors.

At D. Freer & Associates we have a student of osteopathy. As stated by the Canadian College of Osteopathy: “The student of Osteopathy already holds a license, registration or certificate in the health care field, such as physiotherapists… These students already have an active practice. With each new course that the practitioner attends, they are able to integrate the osteopathic philosophy, theory, methodology and techniques into their current practice.”


TMJ (Temporomandibular Joint) Symptoms and Treatment

One of the most common signs of a TMJ problem is the temporomandibular joint making noise such as clicking, popping, or grinding sounds. However, headaches, clenching and grinding of the teeth, ringing or buzzing in the ears, dizziness and loss of balance, and even the jaw locking open or closed are also common symptoms of TMJ disorder.

Treatment may include:
• the use of modalities as required (ultrasound, laser, acupuncture, electrical current)
• education regarding posture and injury prevention
• a careful exercise prescription to address their individual needs and symptoms
• manual therapy techniques including craniosacral therapy and myofascial release to address joint and soft tissue injury
• a referral back to a dentist or physician if any other issues remain outstanding (ie: a night splint)


The symptoms of Vertigo (BPPV) include dizziness, lightheadedness, imbalance, and nausea. Activities which bring on symptoms vary, but symptoms are almost always brought on by a change of the position of the head with respect to gravity. Getting out of bed, or rolling over in bed are common “problem” motions. The most common cause Vertigo in people under age 50 is head injury, and in older people the most common cause is degeneration of the vestibular system of the inner ear.

Treatments involve moving debris or “ear rocks” out of the sensitive part of the ear to a less sensitive location. Treatments involve different maneuvers some involving the patient rapidly moving the entire body and others involving specific movements of just the patient’s head. Treatments are very effective, with roughly an 80% cure rate.

Viceral Manipulation

Visceral manipulation is a “soft” manual therapy technique of gentle manual forces applied to the body to encourage normal mobility of the viscera (the internal organs of the body). If abnormal points of tension in the visceral and fascial system have been identified, the therapist will apply a gentle force and follow the fascial tension with their hands to the restrictive barrier.

Due to the delicate and highly reactive nature of the visceral tissues, very gentle, precisely directed force applied by a highly trained practitioner will be sufficient to achieve results. These gentle manipulations can potentially improve the functioning of individual organs, the systems the organs function within, and the structural integrity of the entire body. Once the release is complete, there will be a sense of lengthening and relaxation in the tissues.

Spinal Manipulation

Low-back pain is a common condition that can be difficult to treat. Spinal manipulation is a possible treatment option that may be used by Registered Physiotherapists. Joint manipulation is a “hands- on” treatment involving a small, high speed, controlled movement to a specific joint to improve function. Some of the scientifically proven benefits of manual therapy are: Pain Relief, Improved joint motion and stability, increased muscle strength and coordination.

Unskilled manipulation of the back (and neck) can cause serious side effects. That’s why a high level of training is vital to patient health. Manual therapists are physiotherapists who have a university degree in physiotherapy, as well as post graduate education and certification by examination in manual and manipulative therapy.

Canadian Academy of Manipulative Therapy