Phase 1: Clinical Diagnostics
VALD Hub Live Data • SF SOMA

Objective Strength & Symmetry Testing

Medical-grade VALD DynaMo dynamometry. We quantify peak muscle force and side-to-side symmetry to isolate deficits and accelerate recovery.

Module 01

Functional Movement Screen

Full Kinetic Chain

We evaluate gross movement patterns across all planes to spot joint compensations, muscle tightness, or instability before loading heavy athletic demands.

SCREEN 01

Overhead Deep Squat

Checks bilateral mobility of hips, knees, ankles, and thoracic spine under gravity.

Target: Heels down, upright torso
SCREEN 02

Single-Leg Step Down

Isolates knee stability, hip control, and dynamic balance on stairs and trails.

Target: Knee tracks over toes
SCREEN 03

Active Leg Raise & Hinge

Assesses hamstring excursion while keeping the pelvis and lower spine stable.

Target: Vertical leg without pelvic tilt
SCREEN 04

Deceleration & Hop Screen

Evaluates how each limb absorbs ground impact during athletic cutting and landing.

Target: > 90% bilateral symmetry
Next, we load specific muscles with the DynaMo dynamometer in Module 02.
VALD DynaMo Live Clinical Cases

Strength & Symmetry Analysis

Click below to explore real patient records and see how deficits are calculated.

Hip Flexion Seated • Protocol: ISO Belt-Stabilized
Left Right Target
Peak Force ↗ Higher preferred
Left 293 N (65.9 lbs)
Right 248 N (55.8 lbs)
64th percentile 46th percentile
Side-to-Side Diff ≤ 10% Goal
15.0% Left Mild Deficit
Finding: Right side is 15% weaker
Limb Symmetry (LSI) > 90% Target
85% Symmetry Target: 90%+
Plan: Close 5% deficit

Repetition Force Outputs

Left vs Right compared to test average

Avg: 262 N (58.9 lbs)
420 350 280 210 140 0 Avg: 262 N 224 N R1 238 N R2 248 N R3 284 N L1 287 N L2 293 N L Peak
• Left   • Right
1 N ≈ 0.225 lbs

Balance Meter

Zero-centered deflection gauge

15% Left
Deflection 15.0% Left
LSI 85% Symmetry
← Left Stronger Right Stronger →

Left limb produces 15% more force than right. Normal athletic tolerance is ≤ 10%. We prescribe focused unilateral loading to eliminate this gap.

> 90% Pass
80–90% Guarded
< 80% Deficit
Module 03

Active Range of Motion (ROM)

Precision: ±0.5° Dual-Axis

Using sensor-based digital goniometry, we record precise joint excursion angles down to the degree to find capsular tightness, impingements, or hypermobility.

Shoulder 15% Diff

Internal Rotation

40° (Left) 47° (Right)
Target: 60° (Both sides restricted)
Shoulder 15% Diff

External Rotation

89° (Left) 105° (Right)
Target: 90° (Right hypermobile)
Shoulder 25% Diff

Shoulder Extension

71° (Left) 53° (Right)
Target: 60° (Right side tight)
Shoulder 0.4% Match

Overhead Reach

183° (Left) 183° (Right)
Target: 180° (Symmetrical)
Goniometric mobility data syncs directly with VALD DynaMo force measurements. Book Mobility Scan →
Fort Point Physical Therapy • SF

Ready for your Phase 1 Evaluation & DynaMo Scan?

Get baseline strength numbers, find hidden muscle imbalances, and build your recovery plan with Dr. Robby Brovarnik.

Phase 2: Symptom Care
Active Recovery • SF SOMA

Targeted Symptom Care & Active Recovery

Downregulating pain, unlocking restricted joints, and reactivating muscles without passive downtime or ice packs.

Manual Care Arthrokinematics

Skilled Joint Mobilization

Gentle, graded manual glides that restore natural roll-and-slide mechanics and modulate joint sensitivity.

Spine & Neck Mobilization • Frees restricted facet joints and calms local tension
Sensory Relief Joint Glide Active Loading
Mechanism Articular Glide
Restores Joint Glide

Restores natural sliding between joint surfaces to eliminate pinch points and stiffness.

✓ Calms articular receptors
Comfort Gentle & Controlled
Gradual, Soothing Motion

Controlled, rhythmic glides and gentle traction applied within your comfortable range.

✓ 100% patient controlled
Goal Movement Window
Expands Pain-Free Range

Reduces joint sensitivity to create an immediate window for active strengthening.

✓ Immediate movement gains

Arthrokinematic Glide vs. Joint Restriction

Convex-Concave Rule
Restricted Motion (Joint Pinches) Guarded
Restored Arthrokinematic Excursion Smooth Slide
Neuro-Orthopedic Manual Care Evidence-based joint therapy

What to Expect

Spine & Neck Focus

Dr. Robby Brovarnik assesses your joint mechanics and applies gentle directional glides to relieve restriction. We re-test your movement immediately so you feel the ease before transitioning to strength.

Session Style 100% Hands-On • 1-on-1
Next Step Active Movement Loading
Modality 01
Manual Care Myofascial Release

Targeted Soft Tissue & Muscle Release

Decreasing protective muscle guarding, improving tissue glide, and stimulating local microcirculation.

Active Pin-and-Stretch Excursion • Frees restricted muscle layers while you move
Local Perfusion Muscle Tone Active Loading
Mechanism Tone Modulation
Downregulates Guarding

Targeted pressure calms hyperactive muscle spindle reflexes, allowing tight bands to relax.

✓ Resets resting muscle tone
Comfort Targeted Depth
Deep Tissue Relief

Comfortable depth that eases focal tension spots without painful poking or bruising.

✓ Light, refreshed feeling
Goal Tissue Glide
Restores Movement Glide

Improves relative sliding between fascial layers and muscle groups during exercise.

✓ Replaces passive downtime

Active Care vs. Passive Rest

Circulation & Motion
Passive Downtime (Static Rest) Low Perfusion
Active Soft Tissue & Guided Movement Active Flow
Mechanotherapy Promotes tissue adaptation

Movement-Integrated Release

Active Excursion

We apply targeted tension while you move the limb through a comfortable range. This sensory feedback teaches your nervous system that it is safe to relax and move again.

Patient Role Guided Active Motion
Clinical Aim Desensitize Tightness
Modality 02
Decompressive Care Myofascial Cupping

Myofascial Cupping Therapy

Controlled negative pressure that lifts superficial tissue layers, promotes local circulation, and relieves tightness.

Movement-Based Dynamic Cupping • Negative pressure combined with active joint motion
Negative Pressure Local Perfusion Sensory Relief
Mechanism Decompression
Lifts Superficial Tissue

Negative pressure gently lifts skin and superficial fascia upward rather than pushing downward.

✓ Separates restricted tissue planes
Circulation Local Perfusion
Promotes Local Blood Flow

The gentle suction draws fresh microvascular blood flow to tight regions, easing stiffness.

✓ Transient healthy hyperemia
Goal Sensory Modulation
Eases Perceived Tightness

Stimulates cutaneous receptors to reduce guarding, creating a comfortable window for mobility.

✓ Science-backed neurosensory relief

Decompressive Lift vs. Downward Compression

Negative Pressure
Downward Compression (Traditional Pressure) Downward Force
Myofascial Cupping Decompression Upward Tissue Lift
Myofascial Decompression (MFD) Evidence-based practice

The Science Behind Cupping

Tissue Decompression

Clinical research demonstrates that cupping stimulates cutaneous mechanoreceptors, modulating sensory input to the central nervous system. When combined with active movement, it temporarily enhances tissue slide and range of motion.

Realistic Markings Temporary Pink/Red Spots
Mechanism Vascular Hyperemia
Modality 03
Smart Modality Low-Load Hypertrophy

Blood Flow Restriction (BFR) Training

Rebuilding muscle strength using light mechanical loads (20–30% 1RM) without high compressive joint shear.

Knee & Leg Strength (ACL, Meniscus, Patellar) • Low-load strength gains sparing joint cartilage
Low Joint Shear Metabolic Stress Muscle Synthesis
Mechanism Metabolic Signaling
Robust Muscle Growth

Venous restriction activates high-threshold Type II motor units using very light weights.

✓ Peer-reviewed hypertrophy outcomes
Joint Load 20–30% 1RM
Minimal Joint Strain

Avoids heavy compressive loads that aggravate healing cartilage or surgical repairs.

✓ Protects healing joint structures
Goal Rehabilitation
Ideal for Early Rehab

Clinically validated for ACL repairs, meniscal tears, and tendon recovery phases.

✓ Prevents disuse muscle atrophy

Heavy Resistance vs. Low-Load BFR

Clinically Validated
Traditional Heavy Lifting (70–85% 1RM) High Joint Shear
Personalized BFR Training (20–30% 1RM) Low Joint Strain
Doppler-Calibrated Bands Individualized LOP safety

How BFR Works

Knee & Leg Focus

Pressure-calibrated pneumatic cuffs temporarily restrict venous return while maintaining arterial inflow. The resulting local hypoxia recruits fast-twitch muscle fibers under very light loads.

Training Load 20–30% 1RM (Low Stress)
Safety Feature Automated LOP Regulation
Modality 04
Neuromuscular Care Motor Re-Education

Targeted Muscle Activation (NMES)

Overcoming Arthrogenic Muscle Inhibition (AMI) when joint swelling or pain reflexively inhibits muscle firing.

Quad & VMO Muscle Re-Education • Overrides reflexive post-injury muscle shutoff
Motor Axon Firing Co-Contraction Neural Drive
Mechanism Inhibition Bypass
Bypasses Protective Shutoff

Following joint effusion, spinal reflexes shut off voluntary output. NMES directly depolarizes motor axons.

✓ Overcomes post-injury muscle latency
Contraction Coordinated Squeeze
Strong Tetanic Contraction

Unlike passive sensory TENS, clinical NMES produces visible contractions paired with active effort.

✓ Co-contracted during exercise
Goal Gait Stability
Restores Normal Gait

Essential for restoring quadriceps torque after surgery and eliminating compensatory limping.

✓ Restores full joint dynamic stability

Inhibited Voluntary Firing vs. Synchronous NMES

Motor Recruitment
Voluntary Effort with Joint Swelling (AMI) Incomplete Firing
Active Superimposed NMES Stimulation Synchronous Recruitment
Motor Re-Education Co-contraction protocol

Active Superimposition

Co-Contraction

We pair muscle stimulation directly with your active voluntary movements. You contract the target muscle together with the stimulation, quickly restoring neural drive for walking, climbing stairs, and athletic drills.

Session Style Exercise Co-Contracted
Objective Abolish Muscle Latency
Modality 05 Book Treatment →
Fort Point Physical Therapy • SF SOMA & Mission Rock

Ready for Active Symptom Care & Targeted Recovery?

Eliminate pain, restore joint mobility, and get back to your active lifestyle. Work 1-on-1 with Dr. Robby Brovarnik.

Phase 3: Performance
Tissue Durability • SF SOMA

Progressive Loading & Athletic Durability

Building lasting movement control, progressive tissue capacity, and athletic resilience for long-term health and performance.

Motor Control Kinematic Alignment

Corrective Movement & Symmetry Drills

Refining movement mechanics, addressing compensatory asymmetries, and restoring joint stability across all planes.

Single-Leg Balance & Hip Control • Split squats, step-downs, and lateral pelvic stabilization
Joint Stacking Symmetry Motor Learning
Symmetry Unilateral Balance
Addresses Compensations

Isolates each limb individually to rebuild balanced neuromuscular firing patterns developed after injury.

✓ Balances side-to-side force
Alignment Kinetic Chain
Improves Joint Stacking

Coordinates foot, knee, hip, and pelvis mechanics to distribute impact forces evenly across joints.

✓ Reduces knee valgus & pelvic drop
Transfer Functional Movement
Bridges Rehab to Daily Life

Progresses isolated table exercises into standing movement patterns that carry directly over to activity.

✓ Dynamic real-world stability

Compensatory Movement vs. Aligned Control

Movement Quality
Compensatory Movement (Knee Cave / Pelvic Tilt) Suboptimal Stacking
Fort Point Corrective Alignment Balanced Axis
Kinematic Control Eliminates compensation

Movement Re-Patterning

Single-Leg Balance

Strength alone cannot resolve an inefficient movement pattern. We coach single-leg control, step-downs, and hinges with immediate feedback so efficient mechanics become second nature.

Feedback Mode Kinematic • Real-Time
Outcome Balanced Muscle Control
Modality 01
Tissue Capacity Mechanotransduction

Heavy Strength & Conditioning

Progressive resistance training designed to remodel tendons, build muscle capacity, and increase joint tolerance.

Multi-Joint Compound Loading • Squats, deadlifts, and split squats coached to your exact anatomy
Mechanotransduction Tissue Reserve 1-on-1 Coached
Mechanism Mechanotransduction
Remodels Tendons & Bone

Controlled mechanical loading signals tenocytes and osteocytes to remodel collagen and adapt to high athletic stress.

✓ Builds tissue load capacity
Capacity Tissue Reserve
Surpasses Daily Demands

Builds physical capacity well beyond your everyday and sporting baseline so fatigue won't trigger setbacks.

✓ Long-term tissue resilience
Delivery Clinical Coaching
1-on-1 Form Precision

Coached directly by a Doctor of Physical Therapy, customizing stance, depth, and tempo to your joint anatomy.

✓ Heavy loading without flare-ups

Tissue Capacity vs. Daily Demand

Load Tolerance Buffer
Baseline Capacity (Narrow Buffer) Prone to Flare-Ups
Fort Point Progressive Tissue Durability High Load Reserve
Progressive Overload Principle Long-term participation

Strength Coaching Protocol

Compound Loading

We progress resistance systematically based on objective VALD force data, building high-level strength for lifting, running, and athletic performance.

Coaching Ratio 1-on-1 with DPT
Primary Goal Tissue Durability
Modality 02
Sport Specific Objective Clearance

Return to Sport & Athletic Clearance

Deceleration drills, change-of-direction mechanics, and objective data benchmarks for confident athletic clearance.

Deceleration & Force Absorption • Drop landings, depth jumps, and multi-planar deceleration control
Force Absorption ≥90% LSI Benchmark Full Confidence
Impact Eccentric Brakes
Absorbs Ground Forces

Trains muscles to act as responsive shock absorbers during sudden stops, landings, and rapid changes of direction.

✓ Protects joints & ligaments
Testing Objective Data
≥90% Symmetry Standard

Clearance is guided by objective data, requiring ≥90% Limb Symmetry Index (LSI) on VALD DynaMo force testing.

✓ Data-backed green light
Mindset Psychological Ready
Restores Full Confidence

Progressively exposes you to sport-specific demands so you return to competition with complete trust in your body.

✓ Compete without second-guessing

Deceleration Absorption vs. Stiff Impact

Ground Reaction Force
Stiff / Unguarded Landing High Impact Spikes
Fort Point Coached Deceleration Muscular Absorption
Biomechanical Safety Joint & tendon protection

Clearance Testing Battery

Landing Control

Before clearing an athlete for unrestricted activity, we evaluate bilateral force symmetry, hop testing, and movement control under sport-specific fatigue.

Passing Threshold ≥ 90% LSI Symmetry
Clearance Status Full Return to Sport
Fort Point Physical Therapy • SF SOMA & Mission Rock

Ready to Build Lasting Strength & Durability?

Bridge the gap between rehab and peak performance. Train 1-on-1 with Dr. Robby Brovarnik to return to your sport stronger than before.