And she feels strongly that emotions (like the fear you feel when you're skiing and realize you're going to tumble) can contribute greatly to an injury. "You can store that emotional and mental energy in those spaces," she said, "contributing to the physical injury."

Powell and Glaser-Gormally are reportedly the only two practitioners of the subspecialty in Utah, although other physical therapists use some aspects of it. Nationally, numerous group practices and individuals are using the techniques, developed first by Sharon Giammatteo, founder of the Center of Integrative Manual Therapy and Diagnostics in Connecticut. There are many private practices as well, such as Glaser-Gormally's Precision Physical Therapy or Powell's Integrated Manual Therapy.

For lower back pain, Glaser-Gormally checks first for a mechanical component to the problem. She examines range of motion and tests strength, two staple assessments of all physical therapy. A mechanical problem must be treated first, but it doesn't always resolve the problem. Next, she said, she'd look at the lymph system and the vascular system, at nerve tension, disk pain, the dura.

Manipulation is "very indirect, into a direction of ease."

Often, she finds that what seems to be the problem is merely a symptom.

Archer learned, for instance, that her shoulder pain probably stems from an old elbow injury. She was compensating to protect it, a natural body reaction, and over time her shoulder and much of the rest of her body got out of alignment. That also contributed to the hip pain.

"My whole right shoulder was raised up and raised forward. She said, 'That's the way you've carried your shoulder in order to protect your elbow, where the injury was.' As we get the shoulder back and down, I am walking straighter, with my weight on both feet," said Archer.

Treatment may depend on finding the tension pattern, a specific line in the body, then working with that line, Glaser-Gormally said, and what it's attached to.

Sometimes only muscle tissue is affected. Or it may go into deeper structures in the body.

Often, the lymph system is also involved and must be cleared.

"We're setting it up so the body can do its own healing," she said.

If that's done, she said, the body can let go of its restrictive patterns and regain normal mobility, tone and motion.

Too often, Powell said, when someone complains that a certain position causes pain, a health-care provider's response is "avoid that position."