Services Offered


Manual Adhesion Release (MAR) is the premier form of soft-tissue treatment to remove adhesion/scar tissue. Adhesion is arguably the number one cause (next to degeneration/arthritis) for muscle and joint pain, unfortunately, the most underdiagnosed condition. Adhesion acts like glue among muscles, fascia, tendons, ligaments, and even nerves. As a result, this reduces flexibility, strength, and stability to the body. Adhesion, along nerves, can cause numbness, aching, tension, tingling, and in some cases weakness. This is called nerve entrapment and can happen at an estimated 156 locations throughout the body. Some common conditions in this scenario include carpal tunnel syndrome, sciatica, and tarsal tunnel syndrome to name a few. MAR is the quickest and most effective way of fixing nerve entrapment. Other common conditions that are treated are impingement of the shoulders and hips, medial shin splints, neck pain, lower back pain, headaches, knee pain (runner’s knee, ITB syndrome, jumper’s knee), and chronically tight hamstrings or quads. 

Instrument Adhesion Release (IAR) is an instrument based form of manual treatment that is designed to effectively remove adhesion without damaging the overlying healthy tissue. It’s also one of the few instruments on the market that has a proper hands-on training program to teach the provider exactly where and how to treat your problem. Common conditions in which IAR work more efficiently than MAR or ART are tendinitis of the Achilles and elbows (tendinopathy), forearm pain, carpal tunnel syndrome, anterior shin splints, and plantar fasciitis. 


Sole Supports custom orthotics are the only, truly custom orthotics that takes into account your arch height, foot flexibility, body weight, and load factors (activities of daily living). These are not cast for every patient, but can be very useful in conditions of the feet, ankles, and knees to fully correct your problem. In many cases, these are beneficial to patients that need longer relief and correction after treatment has fixed the soft-tissue adhesions. This is the only orthotic that stays in full contact with your arch as you move and allows your feet to still accommodate as you put your weight into them. A simple way to test if your current orthotic is working or not is to sit on a chair with your orthotic placed directly where it would be in your shoe. Without putting weight into the ground, does your orthotic contact your arch? If not, it definitely won’t support your arch as you walk, stand, or run. If yes, while remaining in the chair, raise your heel as if you standing on your toes. Lift the back of the orthotic to match up to your foot. Does it remain in contact with your arch? If not, your current orthotic is only 50% effective and does not accommodate for movement. If you are unsure, ask Dr. Nottoli to answer any questions and educate you. Find out more at