The STB Method: Assessment, Compensation Mapping, and Precise Evidence-Based Treatment
The STB Method: An Innovative Approach Integrating Biomechanical Assessment, Movement Mapping, and Personalized Care for Effective and Safe Rehabilitation
In the field of manual therapy, one of the greatest challenges is distinguishing between the site of pain and the source of the problem. Many patients present with localized pain—yet in practice, the root cause lies in dysfunctional movement patterns, tissue imbalances, or compensations the body has developed over the years.
The STB Method – Structural Tissue Balance – was developed specifically for this purpose: to locate, diagnose, and treat the true source of dysfunction, utilizing scientific diagnostic tools and a diverse range of therapeutic techniques.
What is the STB Method?
STB is an integrative therapeutic approach aimed at creating balance between tissues, joints, and the nervous system. It is based on three central stages:
- Biomechanical Assessment: A precise analysis of movement, identifying joint restrictions, and understanding the distribution of mechanical loads.
- Compensation Mapping: Locating patterns where the body "bypasses" restrictions—even if these patterns are distant from the primary site of pain.
- Targeted Intervention: Selecting the most precise technique—HVLA, mobilizations, myofascial therapy, active exercise, or a combination thereof—tailored to the individual's needs.
Why is Accurate Diagnosis the Key?
A practitioner who does not perform a comprehensive biomechanical assessment may end up focusing solely on the site of pain. For example: localized treatment of a painful knee will not resolve the issue if the source of compensation lies in the hip or the ankle.
The STB Method provides the tools to identify the interconnections between different regions of the body, allowing the therapist to reach the true root cause. The result: a more effective treatment with long-lasting results.
A Core Principle of STB: The pain is often merely the "victim," while the source of the dysfunction lies in an entirely different area.
The STB Clinical Workflow
- In-Depth Consultation Reviewing medical history, understanding the nature of the pain, and identifying aggravating and relieving factors.
- Functional Assessment Movement analysis – evaluating gait, sitting posture, squat mechanics, and daily movement patterns.
- Biomechanical Mapping Testing ranges of motion (ROM), muscle balance, and proprioceptive capabilities.
- Identification of Compensations Identifying alternative movement patterns and understanding their biomechanical implications on the kinetic chain.
- Tailored Intervention Selecting the precise combination of techniques – HVLA manipulations, joint mobilizations, myofascial therapy, and rehabilitative exercise.
- Follow-up and Re-evaluation Re-testing after each intervention and continuously adjusting the treatment protocol based on clinical progress.
Integrative Techniques within the STB Method
The core advantage of the STB method lies in its ability to synergistically combine various therapeutic modalities based on clinical necessity:
HVLA (High Velocity, Low Amplitude): Precise manipulations designed to release joint restrictions and restore mobility.
- Mobilizations: Gentle, rhythmic movements utilized to improve range of motion and joint nutrition.
- Fascial Therapy: Releasing connective tissue to reduce mechanical loading and enhance tissue elasticity.
- Active Exercise: Strengthening core musculature, improving motor control, and integrating optimal movement patterns.
Clinical Examples
Case 1: Chronic Knee Pain
The Findings: A female patient presented with chronic knee pain. An STB assessment revealed that the primary source was restricted ankle mobility.
The STB Intervention: Treatment focused on the ankle using joint mobilizations and HVLA manipulations.
The Result: Knee pain significantly decreased as the joint no longer had to compensate for the stiff ankle.
Case 2: Lower Back Pain in an Athlete
The Findings: An athlete presented with lumbar pain. The assessment identified core muscle imbalances and compensatory lumbar hyper-extension during movement.
The STB Intervention: A combination of myofascial therapy, abdominal strengthening (core stability), and targeted lumbar HVLA.
The Result: Marked improvement in both daily function and athletic performance.
Case 3: Cervicogenic Headaches
The Findings: A patient suffering from tension-type headaches. Assessment revealed restrictions in the upper cervical spine alongside thoracic compensations.
The STB Intervention: Integration of cervical HVLA, thoracic mobilizations, and postural corrective exercises.
The Result: A 70% reduction in the frequency and intensity of headaches.
The Advantages of the STB Method
- Precise and In-depth Diagnosis: Moving beyond symptomatic relief to address the underlying biomechanical dysfunction.
- Personalized Treatment Plans: Tailoring every session to the unique clinical needs and compensatory patterns of each patient.
- Synergy of Techniques: Integrating advanced manual therapy (including HVLA) with active functional rehabilitation.
- Evidence-Based Practice: Grounded in scientific research and extensive clinical experience in manual therapy and pain management.
- Wide Clinical Application: Effectively treating patients of all ages and across various physical conditions—from chronic pain sufferers to elite athletes.
Summary
The STB Method is far more than just a treatment technique—it is a comprehensive philosophy for diagnosing, analyzing, and correcting movement patterns and compensations.
By integrating biomechanical assessment, diverse therapeutic modalities, and personalized care, STB empowers practitioners to achieve profound, long-lasting clinical results. It is an essential tool for any professional aiming to operate at the highest level of modern manual therapy.
About the Authors
Eyal Feigin Expert in Manual Therapy, Medical Massage, and Dry Needling.
Givon Peled Founder of the STB Method and Specialist in Pain Management.
Do you want to learn how to implement the STB Method professionally and precisely into your practice?
Selected Research
Bialosky JE, et al. Mechanisms of manual therapy in musculoskeletal pain. Manual Therapy, 2009.
Cook G, et al. Functional movement screening and injury prevention. British Journal of Sports Medicine, 2010.
McGill SM. Low back disorders: Evidence-based prevention and rehabilitation. Human Kinetics, 2015.
Kiesel K, et al. Movement pattern compensation and risk of injury. JOSPT, 2014.
Sahrmann SA. Movement system impairment syndromes. Mosby, 2002.
