What is orthopaedic manual physical therapy?

Physically, orthopaedic manual physical therapy (OMPT) is any “hands-on” treatment provided by a physiotherapist. This may include joint mobilization or manipulation, muscle stretching, nerve glides, passive ranging, dry needling, canalith repositioning, soft tissue mobilization, massage, etc. 

More importantly, OMPT involves precise clinical evaluation of the individual, critical reasoning, and a continuous cycle of assessment and re-assessment, based on the patient’s response to the therapy provided.

Therapeutic exercises and activities, the backbone of physiotherapy, are almost always prescribed in addition to any OMPT to complement, reinforce and magnify the treatment effect.

What is a Fellow / FAAOMPT?

A FAAOMPT is a Fellow of the American Academy of Orthopaedic Manual Physical Therapists.

Fellows are a special group of physiotherapists dedicated to continuing education in practice, education or research.  FAAOMPT is a mark of distinction, internationally recognized for competence and expertise in the practice of manual physiotherapy.  It says your physiotherapist has made—and continues to make—special efforts to be a better physiotherapist.  It says your physiotherapist cares about delivering optimal health care. 

FAAOMPT means that, as a patient, you can have the utmost confidence in your physical therapist’s clinical, analytical and hands-on skills in the treatment of your musculoskeletal condition. Through continual self-improvement and mentored study, the Fellow has added to the knowledge and skills needed to deliver best care for your rehabilitative needs, whether directly with you or by coordinating care with other health care specialists.

How does a physical therapist become a Fellow / FAAOMPT?

Educationally, physical therapists complete their undergraduate and graduate schooling— including their general practice internships-- and are awarded their professional degree (DPT).  After graduating, physical therapists have the option of applying to a residency program to continuing their education and training in a specialty area of practice (orthopedics, women’s health, clinical electrophysiology, etc.) under mentorship from a residency- or fellowship-trained physiotherapist(s).  The physical therapist also has the option, typically after completing a residency program, of applying to a fellowship program, for even further education and training in sub-specialty practice under the mentorship of a fellowship-trained physiotherapist(s).

Total Education:  Entry-Level: 7 years; Residency: 1-3 years; Fellowship: 1-2 years

At the time of this writing there are approximately 210,000 physiotherapists practicing in the United States.  Of those therapists, approximately 1,300 are Fellows.  Of those FAAOMPTS, 30 are practicing in Michigan, and Dr. Gaunt is the only Fellow practicing in Northern Michigan.

Not near Optimum DPT and want to work with a Fellow?  Click hear to find one near you.

What is Osteopractic / an Osteopractor?

An osteopractor is a physical therapist or medical doctor (MD/DO) that has completed the American Academy of Manipulative Therapy's evidence-based post-graduate training program for the diagnosis and treatment of neuromusculoskeletal conditions of the spine and extremities.  Osteopractors specialize in the interventions of high-velocity low-amplitude thrust manipulation and dry needling to treat said conditions.

Osteopractic physiotherapy is an approach to care, a sub-specialty within physical therapy, and more accurately describes the kind of physiotherapy services offered (rather than simply "physical therapy").  When one has a heart condition, they look for a cardiologist. When one has a skin condition, they go to the dermatologist. When your child needs medical care, you look for a pediatrician.  Likewise, when you have neuromusculoskeletal conditions of the spine and extremities (e.g. neck pain, low back pain, headaches, tennis elbow, heel pain, carpal tunnel syndrome, knee osteoarthritis, shoulder impingement, joint pain, etc.), it makes sense to look for a specialist not a generalist within physical therapy that is specifically trained and has advanced post-graduate qualifications to treat those conditions—an osteopractic physiotherapist or Osteopractor.

Osteo- originates from the Greek osteon (“bone”) and –practor originates from the Greek praktikos (“to practice, do, or perform”).  Although the term osteopractor literally translates to “bone practitioner”, the most recent evidence-based practice guidelines for musculoskeletal disorders clearly supports a “multi-modal” approach; therefore, in addition to the joints (i.e. the bones), the direct treatment of muscle, tendons, ligaments and fascia (all connected to the bones…), is recognized within the osteopractic concept for optimal patient management. Likewise, a neurosurgeon does not just operate on nerves during surgery, and osteopaths do not just treat bone diseases.

The term osteopractor has nothing to do with the chiropractic or osteopathic professions; that is, the osteopractor concept is firmly focused on the management of neuromusculoskeletal disorders in an evidence-based fashion, not the treatment of other organ systems as the profession of chiropractic has traditionally engaged.  More specifically, the osteopractic concept does not subscribe to the theory of the “Vertebral Subluxation Complex” as the primary cause of “dis-ease”. In short, osteopractic physical therapists do not diagnose or treat all 10-organ systems as medical, osteopathic and chiropractic physicians are trained and licensed to do, and they do not utilize medicine or surgery as medical and osteopathic physicians are trained and licensed to do.

Not near Optimum DPT? You can find osteopractors and osteopractic trained clinicians here.

What is Dry Needling?

Dry Needling (also known as intramuscular manual therapy) is an intervention which involves inserting either very thin solid filiform or hypodermic needle(s) into the body without injectable medication—thus the “dry” in the name.  The purpose of the therapy is to promote local, spinal cord, and cortical (brain) responses which results in decreased pain, decreased muscle tone, improved mobility, and elicitation of the body’s natural healing processes. 

Dry Needling is firmly based on western/modern medical knowledge and philosophy.  That is, there are no Oriental / Traditional Chinese medical knowledge, philosophy or diagnostic techniques involved. Likewise, Dry Needling does not involve qi or energy, nor are all 10-organ systems influenced.  Dry Needling is a shared procedure, practiced by physiotherapists, physicians, chiropractors, acupuncturists, and others. 

At Optimum DPT we utilize single use, solid filiform needles for patient safety and comfort, and, typically, incorporate gentle electrical stimulation in conjunction with the needling to enhance the treatment effect. On average treatments take 20-30 minutes. Therapeutic exercises and activities are almost always prescribed to complement, reinforce and magnify the treatment effect.

What is Joint or Spinal Manipulative Therapy?

Manipulative therapy is a manual therapy which involves the delivery of a high-velocity, low amplitude thrust to the body. The thrust, or impulse, is frequently, though not always, accompanied by a joint cavitation or sound (pops/clicks) as the manipulative force reaches the joint and causes a stretch of the tissues.  The intent of a manipulative therapy is to decrease pain, decrease sense of stiffness, decrease muscle tone/guarding/spasms, and to improve range of motion and overall mobility. 

Osteopractic physical therapy utilizes multiple lever, mid-range, momentum-induced manipulations which frequently result in multiple joint sounds but are far more gentle and comfortable than traditional “locking” manipulative techniques. 

Therapeutic exercises and activities are almost always prescribed to complement, reinforce and magnify the treatment effect.

What is Blood Flow Restriction Rehabilitation?

Blood Flow Restriction Rehabilitation (BFR) is a cutting-edge therapy in which a medical tourniquet is placed on either the upper arm or thigh and then precisely inflated to occlude the majority of arterial blood flow and all venous blood flow.  With blood flow restricted, therapeutic exercises are then performed at low loads (0-30% of your maximum) and specific dosages. 

Exercising in a deoxygenated state creates a metabolic environment which causes the body to believe that it is under enormous strain.  This stimulates very rapid increases cardiovascular function, muscle growth and strength—gains made even more readily as there is no muscle break down as is experienced in traditional weight lifting due to the low loads used in BFR rehabilitation.  At the same time, the body releases significant amounts of growth hormone and other growth factors which promotes muscle and tendon regeneration, improved blood flow and bone healing.

Treatment effects can be realized in as little as 2 weeks—responses that would typically be seen after 12-16 weeks of heavy exercise without BFR.  BFR is perfect for individuals who are recovery from surgery, too injured or frail to engage in heavy lifting or high-intensity training but need the therapeutic benefits of both.

What is Direct Care? Direct Physiotherapy?

Direct care is a subtype of concierge medicine that is free the influence of the insurance companies.  Typically, the healthcare provider accepts a small group of members into their practice.  Membership cost is small and made on a monthly basis.  As there is no involvement with the insurance company there are no pre-authorizations, authorizations, co-payments, deductibles or benefit limits to worry about.  The health care provider can focus on delivering optimal care, and does not have to employ staff to deal with the insurance company so the cost of that care is lower.  The membership grants the members access to unlimited medically necessary care.  In short, patient-members receive the benefits of a concierge practice, but at a far lower price that is predictable and easy to budget.

So that means...


Your monthly membership investment would cover all of your care at our office.  You will be seen as often as is needed and with no other cost to you!  Sound interesting?  Feel free to contact us at 231-881-9770 to ask any other questions or click the box below!