Core Physical Therapy
healing from the inside out


Explanation of Services

At Core Physical Therapy your treatment will be tailored to your unique needs, based on a thorough evaluation of your current condition and your medical history. A combination of tissue specific exercise and manual therapy will likely be recommended, with an emphasis on empowering you in your own healing process.

Tissue Specific Musculoskeletal Evaluation

Healing begins with an accurate diagnosis of what is involved. This one-hour comprehensive and tissue specific musculoskeletal evaluation allows you to indentify your core source of injury or health goal. Your medical health history will be reviewed for each body system and integrated with specific tissue testing. This combination allows identification of a tissue specific diagnosis. Each tissue heals at a different rate and with a different optimal stimulus or program. Identifying the core source of injury allows your physical therapy program to be effective, time efficient and individually prescribed to meet your specific health needs.

Tissue Specific Exercise Prescription

Each tissue has an optimal stimulus for repair. Creating an individualized exercise program tailored for your health goals and core injury allows you to achieve your goals more efficiently and with success. STEP (Scientific Therapeutic Exercise Prescription) is a tissue specific exercise prescription that is created for your unique health goals or tissue injury.

Exercise does not need to be complicated and it should not be painful. You can achieve your health goals with this unique program that is tissue specific. Dosage will vary based upon your core injury and personal goals. It can be initiated for blood flow to reduce pain, increase circulation and improve the endurance of your tissue. These qualities are often overlooked and key components for healing on a cellular level. They are also important for repetitive tasks such as sitting or using a computer.

STEP is pain-free and progresses rapidly with your participation. The dosage can vary to include elements of pain reduction, endurance, strengthening, flexibility, core stability, breath, ease of movement, and comfort with rest or stillness within the body dependent upon your injury and health goal.

STEP is easily adapted to your home or place of exercise so you may actively achieve your health goals without relying on continual care and treatment. All programs can be adjusted for your personal needs as you progress with ease.

Manual Therapy

Manual therapy is the use of hands on techniques to facilitate the restoration of health and balance in your body. At Core Physical Therapy Kellie has advanced manual therapy training (link to bio) and 16 years of clinical experience using a variety of manual techniques. She determines her treatment techniques based upon your individual health needs, and how your body most optimally responds. Her manual techniques include:

Osseous mobilization and manipulation

The movement of a joint can allow restoration of the body's optimal alignment for ease of movement, reduction of pain, and restoration of full body health. Joint mobilization can be performed throughout a range of movement and with variation of speed dependent upon the body's needs. For example, a spinal mobilization may be performed in an inner range of movement at low speed for muscle tone relaxation, pain control, and improved neuromuscular reflexes. This may allow improved muscle recruitment for biomechanical control of a joint and ultimately ease of movement. Another presentation may indicate treatment of a sustained end range osseous technique with gentle oscillation for improved range of motion such as that necessary with a knee injury, locked spinal facet, frozen shoulder, or after surgical procedure to a joint.

Kellie has advanced training through an orthopedic manual therapy post-graduate training. This allows her to be proficient in both joint mobilization and manipulation techniques. More importantly her training and clinical experience allows her to determine which type of technique may most benefit your healing goal.

Soft Tissue Mobilization

Soft tissue mobilization is the movement of the soft tissue in the body. This may include the muscles, skin, ligaments, tendons, and myofascial tissue around organs. Kellie utilizes various soft tissue mobilization techniques including indirect and direct techniques. An indirect technique may include moving into the tissue's least resistant range thus allowing a relaxation of tissue tone. This then ultimately may allow the tissue to move further when released creating improved range of motion and ease of movement.

Direct techniques may include moving a tissue into a plane of resistance or towards a tissue barrier with a gentle sustained hold. This allows for the inherent crimp wave in collagen to unwind and ultimately increases pain free range of movement.

In addition, soft tissue techniques can be utilized which relate to the neurological reflexes of the body. These reflexes when facilitated with soft tissue techniques can reduce muscle tone and tightness, improve range of range, and inhibit pain.

Determining which techniques to use is dependent upon the individual response of the body. Techniques that Kellie may choose from include myofascial release, visceral manipulation, massage, contract/relax techniques, neural mobilization, strain/counterstrain, and scar release.

Visceral Manipulation

Is the specific placement of soft manual forces to facilitate normal mobility, tone, and motion of the viscera and associated connective tissue. These techniques are gentle and can have profound influence on the individual organs and how these systems affect the structural integrity of the entire body. Kellie's visceral training has been through the Barral Institute founded by Osteopathic Physician Jean-Pierre Barral. In addition, Kellie has pursued clinical mentorship locally in Portland with Dr. Sheila Murphy DC to further integrate these techniques with specific attention to the entire body and how to most appropriately sequence manual techniques to most assist the client.

Scar Release

When an injury occurs or when there is limited range of motion for a sustained period of time the tissue in the body will attempt to heal itself organically. If the body is under a chronic inflamed state due to injury, illness, nutrition, or emotional stress there is an inherent mechanism of healing that the body undergoes to create a state of balance or homeostasis. Often such a process if left independent of guided care may result in fibrosis or scaring. In addition, a procedure such as surgery mechanically facilitates a tissue response that puts an individual at risk for scar development.

The long-term affect of scaring or fibrosis is the loss of optimal movement of the tissue and the potential of pulling or imbalance of the tissue within our body. This may lead to pain or compensation elsewhere mechanically in the body. Scar release can enhance the elasticity of the tissue within our body and re-establishes the appropriate biomechanical integrity and force of tissue. These procedures are performed with hands on techniques. Learning how to self-treat scars with manual techniques and exercise can be assistive in achieving your health goals and optimal movement patterns so that your body can move without pain or compensation mechanically.

Upper Cervical/Cranial and Vestibular Integration

The reflexive relationship of the upper cervical spine, cranium, eyes, vestibular system, and temporal mandibular joint is complex. Symptoms such as pain to the jaw, headaches, tingling to the face, ringing in the ears, nausea, and cervical tension may all be related. The reflexive relationship of these various presentations can create a continual cycle of pain, tone, and mechanical limitation. For example, an upper cervical restriction at C2/C3 can lead to changes in how the jaw moves and how the eyes respond to the visual field. This in turn can lead to more tension in the cervical muscles further facilitating tightness and changes in the mechanics of the neck and jaw. In addition due to changes in the reflexes of the eyes the vestibular system may be affected due to cross over of reflexes resulting in symptoms of dizziness, or nausea.

Kellie has advanced training in the upper cervical spine and utilizes manual techniques and exercise prescription that restores a balance between these systems. Exercises and techniques may include those to the cervical spine, vestibular system, jaw, or to the eyes.

Spinal Health Conditioning

Statistics indicate that most people will have neck or back pain at some point of time in their lives. Rest assured there is much you can do to prevent such occurrences or minimize repetitive occurrences should they occur. Understanding elements such as tissue specific exercises, biomechanics of the spinal joints, loading patterns, anatomy of the fascial planes, scar tissue release, and the reflexive relationship of the nervous system to the viscera organs and the spine can assist you in maintaining optimal health of your spine. At Core Physical Therapy there is emphasis on client education and less reliance on practitioners for maintenance of your spinal health. Care is provided that will review anatomy, biomechanics, individualized exercise prescription, core stabilization, and influences of systemic health and how these may affect the spine.

Joint Stabilization

After an injury such as a car accident or with sustained biomechanical compensation within the body a joint may become unstable or hypermobile. This is ultimately due to ligamentous laxity, and muscle inhibition that reduces specific control of a joint's range of motion. Over time this hypermobile joint will often become painful due to tissue inflammation and elongation beyond it's optimal range of motion.

Hypermobility may also be related to systemic sources of inflammation or hormonal metabolism. For example, environmental illness, perimenopause/menopause, insulin changes, and other immune conditions can all affect the range of motion of a joint segment.

Identifying hypermobile joints if they are present is important for the long term health and wellness within the skeletal system. Often a hypermobile joint exists with other segments of the spine that may have joint restriction. Protecting hypermobile joints is not difficult once identified through the examination and must be included in a program for optimal outcome of care. Individual exercise prescription and manual techniques that are precise in their biomechanical forces and range allow for such protection. Dosage of movement is important during this stage of care and is provided with all programs at Core Physical Therapy to address your individual core injury or health goal.


Core Physical Therapy · 443 NE Knott Street · Portland, Oregon 97212

Kellie Barnes

Kellie Barnes, MOMT, MPT

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