Yesterday a client asked me a simple but important question:

“How does this integrative manual therapy actually work?”

What is it? Why does it help chronic pain, running injuries, autoimmune issues, and long-standing conditions when nothing else has worked?

This post is my answer.

I’ve been a physical therapist for 40 years, and for most of that time I’ve practiced Integrative Manual Therapy (IMT) — a system developed over 50 years ago by the late Sharon Giammatteo PT, PhD, IMTC and Tom Giammatteo DC, ND, IMTC. Their work has changed the lives of thousands around the world… including mine.

The Core Principle: Your Body Is Always Protecting Something

If you’re dealing with:

• a chronic pain that returns again and again
• a running injury that won’t heal
• a persistent sports injury
• an autoimmune challenge
• or a condition doctors can’t explain

…there is always a reason. And if your pain keeps returning even after standard care — chiropractic, massage, stretching, strengthening — that’s not a sign of failure. It’s information. It means the true root cause still hasn’t been treated.

Your body is smart. If something keeps tightening, hurting, or breaking down, it’s protecting something deeper.

The IMT Approach: Find the Root Cause, Not the Surface Problem

Most therapies try to manage symptoms:

• loosen a tight muscle
• mobilize a stiff joint
• stretch, strengthen, medicate

Useful sometimes, but rarely curative. IMT works differently.

We use a hands-on diagnostic process called myofascial mapping. This lets us feel where the real dysfunction is — through the body’s fascial, organ, vascular, and neural systems.

We can identify whether the root issue is in:

• muscles
• joints
• nerves
• arteries or veins
• organs (heart, liver, colon, lungs, urogenital structures)
• connective tissue
• autonomic or spinal systems

Then we use inhibitory balance testing to discover:

👉 What’s primary
👉 What’s a compensation
👉 What your body is trying to protect

When you fix the primary issue, everything downstream starts to improve.

A Simple Analogy: Why a Wound Won’t Heal

A wound that won’t close could be because of:

• high blood sugar
• an infection
• dehydration or malnutrition

If all you do is change the bandage, nothing changes. IMT uses this same reasoning on the entire body. You don’t treat the thing that hurts — you treat the thing that causes the thing that hurts.

My Story: The Injury That Changed My Life

When I was 37, I was:

• running 70–90 miles per week
• running a thriving San Diego clinic with five PTs
• feeling strong

Then one day a calf spasm shut my running down completely — for eight months.

I tried everything: stretching, massage, strength work, three different pairs of orthotics, rest and ice — even having my own staff work on me. Nothing helped.

Finally I went to an IMT therapist in Los Angeles. She performed myofascial mapping and immediately found the real problem:

My heart and aorta were restricted. My calf wasn’t the issue. It was the protection pattern.

She treated the cardiovascular restrictions — gently, indirectly — and two days later I was running again. Pain-free. That one experience permanently changed how I treat people.

The Correction: Healing Through Indirect Techniques

Instead of forcing tissue to move or stretch, IMT uses indirect corrections:

• slackening the tissue
• calming the nervous system
• allowing the body to reorganize itself
• letting the structure self-correct

This is essential for delicate systems like organs, arteries, veins, nerves, and fascia — where force can actually make things worse. These gentle techniques often create profound shifts.

IMT Is Truly Holistic

We don’t just look at symptoms. We look at the whole person — including deeper emotional, neurological, and mind-body-spirit components. Many times the root cause isn’t physical at all. That’s a topic for a future post.

If Your Condition Hasn’t Healed, There Is a Reason

Pain that keeps returning is a clue. Your body is pointing toward something deeper. The moment we identify the true root cause, change begins — often quickly.

You can get a myofascial mapping assessment with me:

• In-person at Beyond Limits Physical Therapy in Fairhaven (Bellingham, WA)
• Online via Zoom from anywhere in the world

During your session, I’ll show you:

• what’s going on
• what’s primary
• what your body is protecting
• and what to do next

When you treat the right thing, healing happens.

Let’s Get You Back to Doing What You Love

If you’re ready to get back on the trails, back on the track, and back to the life you want…

Ralph Havens — physical therapist & integrative healer with 40+ years in clinical practice. Offering Helix Biomechanics and hands-on integrative manual therapy in Fairhaven, Bellingham, and online.

Learn more: ralphhavens.com