Manual Therapy

We are currently unable to offer manual therapy for telehealth visits.

All the Evolution physical therapists are able to incorporate manual therapy techniques into our in-person treatment sessions. Manual therapy may be useful to improve joint or soft tissue mobility, to reduce pain caused by a disruption in the transfer of forces through a joint, along a muscle or other soft tissue. Our therapists have received post-graduate training in the specific manual therapy techniques described below:

Visceral Manipulation

Visceral Manipulation is a technique developed by French osteopath and physical therapist Jean-Pierre Barral. This approach involves applying a gentle stimulus to the fascia and ligaments of the pelvic, abdominal and thoracic organs to reinstate mobility within the visceral (organ) and musculoskeletal (muscle and bone) systems. While all body systems (including our organs) require movement to maintain optimal health, after injury any tissue can lose mobility due to the normal inflammatory process. Injury to the organ system, such as infection, direct trauma, or abdominal surgery, and history of chronic illness such as irritable bowel syndrome or dysmenorrhea can result in decreased organ mobility, leading to chronic organ related pain. In addition, a decrease in organ mobility may be overlooked as an underlying driver in musculoskeletal pain due to fascial links between the organ and musculoskeletal systems. Visceral manipulation can complement a more traditional physical therapy intervention with the goal of treating the whole person. Evolution physical therapists Alison Aiken, Michelle Downing, and Meagen Satinsky are all trained in visceral manipulation.

Functional Manual Therapy

Functional Manual Therapy (FMT), developed by Gregg and Vicky Johnson of the Institute of Physical Art, is a manual therapy system which looks at the whole person through evaluating mechanical restrictions of joints and soft tissues, neuromuscular capacity, and movement patterns to find both the root cause of injury as well as work towards the goal of improved health and well-being. Seen through the FMT paradigm, the body does not consist of individual areas which work independently of one another, but muscles and joints which work in an interdependent way to create mobility and stability. While pain may be felt in one area of the body, there may be contributing factors from soft tissue or joint restrictions, poor muscular engagement or faulty movement patterns which contribute to symptoms. Treatments using the FMT approach involve the application of manual therapy to joints, muscles, fascia and nerves during active movements with the goal of improving function. Muscular engagement is enhanced through the use of Proprioceptive Neuromuscular Facilitation (PNF), a hands-on exercise technique developed to enhance the body’s own inherent strength and stability. In order to prevent the return of symptoms, attention is also paid to the modification of daily activities such as sitting, sleeping, standing and a comprehensive home exercise program is prescribed. Physical therapist Dr. Michelle Downing is a certified functional manual therapist (CFMT)

Craniosacral Therapy

Craniosacral therapy, developed by William Sutherland, is a manual therapy that has its roots in Cranial Osteopathy. After studying with Sutherland in the 1970’s, Dr John Upledger developed Upledger CranioSacral Therapy (CST), utilizing a subtle touch to detect and release restrictions in the craniosacral system to improve the functioning of the central nervous system.

The craniosacral system consists of the brain and spinal cord which are enveloped in cerebrospinal fluid that’s produced within the system, as well as a membrane called the dura mater. This system has a rhythm, similar in idea to that of an arterial pulse. The rhythm is a reflection of the movement of the cerebrospinal fluid within the dura mater and intracranial membranes that line the skull. Since the CranioSacral system is connected to your bones, muscles, and organs through fascial networks, a CranioSacral therapist can detect the rhythm anywhere in the body. The rhythm’s quality at different locations in the body helps to recognize and treat problems throughout the body by means of subtle touch.

The dura mater is attached at one end to the cranial bones and at the other end to the sacrum. This design allows the cranium and sacrum to be used as a sort of steering device in order to perform subtle manipulations of the bones to release relevant restrictions in the dura mater and surrounding membranes. This approach is practiced worldwide and is effective for a wide range of medical challenges associated with pain and dysfunction including migraines, chronic neck and back pain, concussions and traumatic brain injuries, chronic fatigue, stress and tension related problems, TMJ, PTSD, post-surgical dysfunction. Physical therapist Meagen Satinsky is trained in Cranial Sacral Therapy.

Pelvic Floor Therapy

Evolution Physical Therapy’s pelvic floor therapists, are trained to evaluate and treat issues that arise due to a dysfunctional pelvic floor. We treat clients of all genders who experience pelvic floor issues. Symptoms treated may include urinary incontinence, urge, pain during sex, pelvic, hip, and low back pain. During the postpartum phase splitting of the abdominal muscles may limit women from strengthening their core. Our therapists can teach you how to close the split and regain your abdominal function. Treatment sessions include a comprehensive evaluation of abdominal, back, hip and pelvic floor function, biofeedback training, release of tight muscles, and retraining of weak muscles. If you have had a c-section or episiotomy, you may be taught how to perform scar tissue massage. Our therapists are all yoga instructors and may prescribe a home yoga program to improve your hip mobility and core strength to help you achieve your goals. The initial evaluation is 60 minutes and follow-up sessions are 45 minutes long. We typically see clients for 6-8 sessions every 1-2 weeks until the issue is resolved.

Dry Needling

Janet Carscadden DPT and Meagan Satinsky MPT have gone through advanced training in order to offer dry needling. Dry needling is the use of a thin, solid filament needle, inserted into taut bands of muscle, tendons, ligaments, musculotendinous junctions, teno-osseous junctions, and bone, as indicated after a complete physical therapy evaluation. The goal of dry needling is to restore normal muscle and joint function and to reduce pain.

Dry needling is not the same as acupuncture. Dry needling is based on western anatomy and neuroanatomy, the understanding of pain pathways and current pain theory. Dry needling is not done along traditional Chinese meridians, nor is it used to alter the flow of Qi or energy.

Conditions that may benefit from Dry Needling include chronic pain conditions, myofascial pain, trigger points, plantar fasciitis, tendinitis, neck pain, back pain, headaches (cervicogenic, tension-type, migraine), rib syndromes, facet joint syndromes, cervical and lumbar radiculopathy, and shoulder impingement syndrome.

Dry Needling is covered by a small number of insurance plans. We charge $35 for up to 30 minutes of Dry Needling when the treatment is provided in conjunction with other physical therapy procedures.

Please contact our office for other questions regarding the services that we offer or to schedule an appointment: 802-864-9642

Telehealth

When is Telehealth Appropriate?
If you are unable to come to the clinic due to Covid precautions, childcare issues, transportation issues or inclement weather, telehealth allows us to still see you and offer comprehensive treatment. We especially love telehealth visits to look at your home office or workstation set-up. We can offer ergonomic solutions that meet your unique needs.

What to expect with a telehealth visit
With video conferencing, we are able to see you in real-time, take a thorough history, assess range of motion, strength, movement disorders, gait, and evaluation of functional performance. Treatment may include instruction in pain management strategies, activity modification, posture correction, instruction in a home exercise program including yoga, stretching, strengthening, breathing exercises, balance, and functional exercise. If you are working from home, we assess and provide feedback on your home office set-up. Please reach contact pt@evolutionvt.com if you have questions about whether your condition can be treated via a telehealth visit.

What do I need for a telehealth visit?
You will need a computer, laptop, or other internet enabled device with a webcam and microphone. Plan on wearing comfortable clothes and try to find a relatively quite, low distraction space where you can move freely.
How do I schedule a telehealth visit?
Just call our office at 802-864-9642. First, we will need to gather information about your diagnosis and insurance information for billing. Our scheduler will call you to gather insurance information and will confirm if we have your referral (only needed for Medicaid and Medicare). They will email you an invite to our online patient portal and a link to the telehealth waiting room.

Referrals, notes, or diagnostic reports from other providers that may be helpful to your physical therapist. Please have them fax these reports to 802-864-9643. Wear loose comfortable clothing such as shorts for back or lower extremity injuries or a tank top for upper body issues.

Yoga Therapy

Yoga is a physical, philosophical and therapeutic practice. Our physical therapists are both yoga instructors and have specialty training or certifications in yoga therapy. Yoga may be integrated into physical therapy sessions when appropriate to achieve goals for treatment. Through postures, breath work, systematic relaxation and meditation, yoga offers a path for treating the whole person and developing long-term pain and stress management strategies. By offering both private sessions, group classes, workshops and series, Evolution strives to assist our clients in making lifelong changes to how they approach their health. Whether you are new to yoga or an experienced practitioner, our staff of therapists will help you develop a yoga practice that meets your therapeutic goals.

Yoga is the journey of the self, through the self, to the self – The Bhagavad Gita

Private Yoga

Yoga is an ancient practice that can be used for healing the body. At Evolution our physical therapists are also certified yoga instructors or yoga therapists. Rachel de Simone DPT, RYT, Meagen Satinsky PT, PYT, Patsy Tyler DPT, Janet Carscadden PT, DPT, E-RYT and Michelle Downing DPT, RYT will work privately with individuals to develop custom yoga programs. Sessions may include pranayama (breathwork), meditation, alignment-based yoga sequences, restorative poses, and guided relaxation. The first meeting includes a brief consultation to review the client’s medical and yoga practice history, establish goals for the yoga session, and develop a therapeutic yoga sequence.

Fees for private yoga:

Initial 60-minute Private Yoga Consultation – $100

Follow up 60-minute Private Yoga session – $80

Call our office at 802-864-9642 to schedule an appointment.

In some instances, your physical issue may require a thorough evaluation and in those cases, a physical therapy evaluation is recommended so that a complete assessment can be performed. Physical therapy is covered by insurance and will be billed according to your insurance contract. The appointment must be scheduled as a Physical Therapy Evaluation.

Yoga Wall

Find more ease and strength in your practice and in your body at the Yoga Wall. We use straps and bars on our wall to provide assistance

in poses, deepen twists, traction the spine, and provide support to joints to discover how good proper alignment can feel. We integrate the use of the yoga wall into our physical therapy sessions, private yoga sessions and offer yoga wall classes and workshops. We have yoga walls in two of our private treatment rooms and a 12 station wall in one of our studios. Many yoga wall poses can be performed at home using a simple strap and anchor set-up. Join us for the following yoga wall classes. Yoga Wall is not appropriate for women who are pregnant and who have not been on the wall before. Sign Up to reserve your place as classes are limited to 6 people during Covid for distancing and can fill up. Reserve your spot here.

Drop-in Yoga Wall Classes:

Mondays 5:45-7:00 Yoga Wall with Meagen Satinsky PT, PYT

Fridays 12:15 – 1:15 Yoga Wall with Michelle Downing DPT, RYT

Therapeutic Yoga Classes/workshops/series

We offer the following yoga therapy classes and workshops/series to address specific needs or target areas

Drop-in Classes:

Tuesdays 5:45 – 6:45 Oct – May Yoga Therapeutics: Spine and Hips with Janet Carscadden, PT, DPT, E-RYT

Wednesdays 12:15 – 1:15 Yoga Therapeutics: Hips with Rachel de Simone DPT, RYT

Thursdays 12:15-1:15 Yoga Therapeutics: Neck and Shoulders with Alison Aiken, PT, DPT, CYT

Series:

Yoga For a Healthy Back 6-week Series

Workshops (check current schedule here):

Yoga Nidra

Yoga Therapeutics: Pelvic Floor Basics

Balancing the Nervous System

Yoga Wall: Pelvis and Hips

Yoga Wall: Hamstrings

Yoga Therapeutics: Psoas Release Workshop

Translation Services

We offer access to phone translation services for all of our visits. Please let our office staff know if you or a client is in need of translation services and we will arrange for a phone translator during their session. Translation services are covered by your insurance plan.